The opportunity of vitrectomy for opening eyeball injury is one of the important factors affecting the prognosis.Anterior segment wound repaired by routine suturing needs following and continuous treatment with vitrectomy.The key technique of the following treatment should be the debridement of the inside of wound and expurgation of the surrounding tissues adjacent to the wound,and the emphasis should be put on retinal reattchment and stable repairment.

Objective To compare the clinical effect of C3F8 and air tamponade after vitrectomy for the treatment of idiopathic macular hole (IMH).Methods A total of 54 eyes of 54 patients with IMH that had undergone 23G pars plana vitrectomy with internal limiting membrane peeling were retrospectively studied.All patients received optical coherence tomography ()CT) examination and the best corrected visual acuity (BCVA).They were divided into 2 groups.26 eyes in group A were filled with air and 28 eyes in group B were filled with C3F8.In group A,6 eyes at stage Ⅱ,20 eyes at stage Ⅲ,the minimum diameter (Dmin) of macular hole in 14 eyes was less than 400 μm,and in the other eyes was larger than 400 μm.In group B,10 eyes at stage Ⅱ,18 eyes at stage Ⅲ,the Dmin of macular hole in 15 eyes was less than 400 μm,and in the other eyes was larger than 400 μm.The differences of age,course of the disease,BCVA,fundus diameter,Dmin,height,index,diameter of outer retina diameter (Dord) between the two groups were not significant (P＞0.05).The basic data before surgery and the closure rate,BCVA,Dord 1 month after surgery between two groups were compared.Results At 1 month after surgery,the IMH closure rate was 100.0％ in group A and 92.9％ in group B,the difference between these two groups was not significant (P=0.491).The closure rate of eyes with Dmin＜400 μm were both 100.0％ in two groups,and the closure rate of eyes with Dmin＞400 μm were 100.0％ in group A and 84.6％ in group B.There was no statistically significant differences between two groups (P =0.480).The mean BCVA of two groups were 0.35±0.22 and 0.33 ±0.16 respectively.The mean Dord were (782.2 ± 478.0) μm and(792.1 ± 432.7) μm respectively.All cases got better BCVA (t=-7.310,-10.506;P＜0.01) and shorter Dord (t=6.704,7.770;P＜0.01).But there was no statistically significant differences between groups 1 month after surgery in BCVA and Dord (t =0.381,0.800;P =0.705,0.937).Conclusion Air tamponade after vitrectomy has the same efficacy as C3 F8 tamponade in the treatment of IMH.

Ovjective To observe the surgically excised specimens from eyes with hemorrhagic agerelated macular degeneration (AMD).Methods Thirty-six surgically excised specimens were captured from 36 patients with hemorrhagic AMD,26 specimens were diagnosed as occult choroidal neovascular membrane (CNVM),10 specimens were diagnosed as polypoidal choroidal vasculopathy (PCV).All specimens were routinely processed by hematoxylin and eosin,periodic acid-Schiff's stain and Masson stainings.At the maximum horizontal and vertical slice of the specimens,the category and amount of the cells in the specimen were recorded,as well as the relationship between the specimens and the surrounding tissue.Results The 36 specimens are categorized as neovascular membrane dominant (19/36),collagen fiber dominant (6/36),blood clot dominant (8/36) and degenerated thickened Bruch's membrane dominant (3/36).Eighteen occult CNVM specimens and 1 PCV specimen are categorized as neovascular membrane dominant; all 6 collagen fiber dominant specimens are occult CNVM; 1 occult CNVM and 7 PCV specimens are categorized as blood clot dominant; and 1 occult CNVM and 2 PCV specimens are categorized as degenerated thickened Bruch's membrane dominant.The occult CNVM categorized as neovascular membrane dominant present as small blood vessel with single endothelium cell attached; the PCV specimen categorized as neovascular dominant presents as big blood vessel with thick vessel wall under the Bruch's membrane,retinal pigment epithelium and choroidal melanocyte are both observed in the PCV specimens.Conclusion The components of the specimens captured from eyes with hemorrhagic AMD are diversified.

Optic nerve injury may occur at any section from the eyeball up to the brain. There should be enough mechanical power acting on the skull to result in severe optic nerve injury. Loss of light perception immediately after injury would be followed by an unfavorable prognosis. Efficacy of decompression procedures on optic nerve canal has not been demonstrated. large doses of adrenocortical steroid may be beneficial for early recovery of visual function. Based on the observation in animal model of partial injury, the capability of regeneration of optic nerve was closely associated with the extent of the injury. The enviroment for regeneration of partially injured optic nerve fibers is different from that of complete injury. The irreversibly injured fibers may have more regenerative potency than partially injured optic nerves.

Objective To investigate the effect of Hupo Xiaoshi granules on renal tissue pathological changes and IL-1β, TNF-α and IL-6 in blood of nephrolith model rats. Methods Sixty SD rats were divided into normal control group 10 rats with purified water by intragastric administration(IG),and model group 50 rats with ethylene glycol, calcium and vitamin D3 by IG for 4 weeks to get kidney stones animal models. The successful model rats were randomly divided into model control group, potassium citrate solution group, Hupo Xiaoshi granules low, middle and high dose group (3. 335,6. 670,13. 340 g ? kg-1 , respectively), 10 rats per group with the corresponding drugs. Four weeks later, rat's renal tissue sections were stained with hematoxylin and eosin, renal tissue changes of calcium stones and pathology were observed.Plasma concentrations of IL-1β, TNF-α and IL-6 were detected by ELISA. Results Compared with the model control group, no renal interstitial hemorrhage and a few or no visible renal tissue calcium crystal deposition in the low, middle and high dose Hupo Xiaoshi granules group. In the normal control group, model control group, potassium citrate solution group, and low, middle and high dose Hupo Xiaoshi granules group,the plasma concentrations of IL-1β were respectively(50.50±13.54),(104.00±24.13),(93.00±20.08),(77.00± 25.21),(71.30 ±26.60),(65.50±26.18) pg?mL-1 ,respectively;those of IL-6 were(570.10±119.74),(1 040.00±260.15), (861.40±130.04),(740.00± 161. 31),(680. 00 ± 239. 49),(640. 00 ± 238. 42) pg?mL-1 ,respectively;and TNF-α plasma concentrations were(470.30± 154. 63),(1 010. 00 ± 230. 94),(820. 00 ± 192. 12),(830. 50 ± 110. 01),(720. 00 ± 140. 28), (715.00±173.54) pg?mL-1 ,respectively. Compared with the model control group, the plasma concentrations of IL-1β, IL-6 , TNF-α of the low, middle and high dose Hupo Xiaoshi granules group were significantly decreased (P<0.05 or P<0.01). Conclusion Hupo Xiaoshi granules can inhibit renal tissue pathological changes of nephrolith model rats, inhibit calcium crystals stones deposition in renal tissue, and reduce blood levels of inflammatory cytokines.

Objective To create a calibrated animal model of graded optic nerve injury (ONI) in rats, focusing on quantification of injury intensity, injury severity and the correlation between them. Methods A pair of cross-action forceps with pressure of 148.0 g was used to clip rat optic nerves for 3, 6, 30 and 60 seconds, or a pair of artery clips with constant pressure (32.4 g) used to clip rat optic nerves for 5, 10 and 15 seconds in order to create graded ONI animal models. Transcranial FluoroGold-labeled retinal ganglion cell (RGC) was used to observe the changes of RGC one month after injury, which then could be used to evaluate the injury severity. Ocular blood supply was evaluated by transcardiacly perfused Luxol Fast Blue post-injury. Results The graded ONI animal models were successfully created in rats without retinal ischemia post-trauma. The injury intensity could be well-defined by impulse or averaged impulse, while injury severity could be evaluated by the count of FluoroGold-labeled RGCs. The averaged impulse produced by artery clips clipping rat optic nerves for 15 seconds equalized with that produced by cross-action forceps for three seconds. The severer injury intensity begot less number of RGCs. The correlation between injury impulse and RGCs was fit for power function. Short time clipping of optic nerves could not lead to ischemic injury of the retina. Conclusions A calibrated graded ONI animal model is successfully created by clipping optic nerves with a pair of cross-action forceps. The model can be evaluated with RGCs count, impulse and averaged impulse, the latter two of which stand for injury intensity and injury severity, respectively.

Objective To examine and evaluate the ability of spontaneous regeneration following various extent of incomplete injury in adult rats. Methods The quantities and reduplicated various extent incomplete injured model of adult rats optic nerve was established using different wounding time with constant wounding force produced by across action forceps at 2mm behind eyeball. GAP-43 (growth associated protein-43) and its mRNA expressions were detected with immunohistochemistry (IHC) and reverse transcription polymerase chain reaction (RT-PCR). All data were analyzed by ANOVA. Results GAP-43 and its mRNA expression levels revealed that there was negative response at the distal area contrast to the strong positive response at the proximal in earlier period after injury until half mouth. One mouth later, the increased GAP-43 and its mRNA expression levels became more and more high and reached the climax at second month post injury. Then it decreased gradually. The result of RT-PCR showed there are significant difference among the various extent incomplete injured models and different time after injury. Conclusion Spontaneous regeneration of adult rat’s optic nerve can be detected and identified following incomplete injury, and the extent of regenerating ability is correlated with the extent of injury.

To establish a model of experimental retinal detachment and reattachment, extracapsular lens extraction and vitrectomy were performed in 78 adult cats. After three weeks, a glass micropipette with a flat tip (diameter 150～200?m) was inserted between the neural retina and retinal pigment epithelium (RPE) monolayer. Retinal detachments were produced by subretinal injection of 0.25% solution of Healon through this micropipette. Twenty～four hours later, detached retinas were reattached by air-fluid exchange and subretinal fluid drainage with a glass micropipette. Then 30% perfluoropropane (C 3F 8) gas temponade was porfomed. Retinal detachment was successfully made in 93.6%(73/78), and 97.1%(33/34)of the detached retinas were successfully reattached. By light microscopy, histologic sections showed that seperated retina located between RPE cells and photoreceptors, and neural retina contacted to RPE cells closely in reattached retinas. In conclusion, by using micropuncture, we have established an animal model of retinal detachment and reattachment with minimum injury to the retina, and a high rate of retinal detachment and reattachment were obtained.

Objective To study the healing process of penetrating injury of sclera. Methods A rabbit model with penetrating injury of sclera was made by incising the sclera accompanied by intravitreous injection of autologous blood. The animals were sacrificed at different time intervals after injury. Two hours before the animals were sacrificed, 3 H thymidine ( 3 H-TdR ) was injected into the vitreous cavity. The enucleated eye balls were fixed, dehydrated, embedded with paraffin, and sectioned for light microscopic examination and autoradiographic study. The numbers of cells that incorporated 3 H-TdR at different time intervals were compared. Results After the sclera was injured, inflammation occurred mainly in the superficial part of the sclera, from which most of the proliferating cells filling the wounds came. These cells grew along the vitreous strands to the blood clot in the vitreous cavity. Tractional retinal detachments were induced in 9 of the 12 rabbits within 2 weeks after injury. Cells of different ocular tissues incorporated 3 H-TdR, of which the cells from superficial sclera accounted for the majority. Incorporation of 3H-TdR by these fibroblasts peaked on the 5th day after injury(P

Objective To observe the effect of selective intra-arterial thrombolytic therapy for central retinal artery thrombosis. Methods 100 000-250 000U of urokinase were injected into the ophthalmic artery via a catheter in the ophthalmic artery or the internal carotid artery to carry out the thrombolytic therapy. Results The visual acuity was significantly improved from light perception or finger counting to 0.1 in 8 of a total of 26 cases, partially improved in 10 cases, and no change in vision in 8 cases. The time interval from the onset of the disease to thrombolysis was within 8 days in the 18 patients who showed improvement, 3 of them showed significant improvement, of whom 2 received the treatment within 3 days. Conclusion Selective intra-arterial thrombolytic therapy is effective for the treatment of central retinal artery thrombosis. The effect was closely related to the time interval from the onset of the disease to thrombolysis. The thrombolytic therapy should be carried out as soon as possible.