Ocular surface disorders can be caused by the drug-derived toxicity,adverse effect and abuse of eye drops,and usually these disorders present with unspecific and untypical clinical findings.So the eye abnormality induced by topical administration of eye drops often is confused with some corneal inflammatory diseases.In addition,pathogenic mechanisms vary widely due to the different types of eye drops.Therefore,difficulty of diagnosis and poor curative effect often is a challenge for us.Ophthalmologist should be aware of the toxicity derived eye drops on ocular surface.Several noticeable problems of diagnosis and treatment of drug-derived keratopathy were elaborated in this paper.

The concentration of 5 nucleosides, uracil, uridine, guanidine, adenine and adenosine in culture of Paecilomyces hepialid was determined by the developed method of HPLC. The HPLC method was performed on a Waters SunFire C18 (4.6 mm x 250 mm, 5 μm) column with methanol-water gradient elution as the mobile phase. The detection wavelength was 260 nm and the colunmn temperature was controlled at 30 °C. The linear range was 10.00-200.00 mg · L(-1) (r = 0.9994) for uracil, 10.10-202.00 mg · L(-1) (r = 0.9992) for uridine, 10.00-200.00 mg · L(-1) (r = 0.9991) for guanidine, 10.30-206.00 mg · L(-1) (r = 0.9992) for adenine and 10.45-209.00 mg · L(-1) (r = 0.9991) for adenosine, respectively. The RSD of precision was 0.032%, 0.035%, 0.039%, 0.049%, 0.00080%, respectively. The average recoveries of uracil, guanidine, adenine, and adenosine were 97.34%, 99.10%, 101.6%, 98.61% and 100.2% with RSD of 1.3%, 2.1%, 0.96%, 0.95%, and 1.3% respectively. The method showed high sensitivity, good selectivity, linearity and repeatability, which was suitable for the content analysis of 5 nucleosides components in P. hepialid and its extracts.
Chromatography, High Pressure Liquid ; methods ; Nucleosides ; analysis ; Paecilomyces ; chemistry

AlM:To compare the functional and cosmetic effects of two different surgical techniques for congenital ptosis.
METHODS: The patients were divided into four groups according to the operation method: Patients undertook bilateral fascial suspension surgery as Group A ( 42 eyes of 21 cases ); Patients undertook bilateral levator muscle shortening surgery as Group B ( 38 eyes of 19 cases );Patients undertook unilateral fascial suspension surgery as Group C ( 24 eyes of 24 cases ); Patients undertook unilateral levator muscle shortening surgery as Group D (29 eyes of 29 cases). Each group patients were followed for postoperative function and appearance effect.
RESULTS: 1 ) Early postoperative of two operation function success rate was up to 100%, the function of levator muscle shortening surgery was 97. 01% in the late postoperative, was higher than bilateral fascial suspension surgery (87. 88%), with statistical difference in both surgerys (P<0. 05). 2) Appearance effect of two kinds of operation method in early postoperative had no statistical difference (P >0. 05); ln the late postoperative, the mean grades for “Lid Contour” and “Lid Crease” of Group B were better than that of Group A (P<0. 01). While the mean grades for “Lid Contour”, “Symmetry of Lid Height” and “Lid Crease” of Group D were similarly better than that of Group C (P<0. 01).
CONCLUSlON: Two kinds of operation method have good effects on the treatment of congenital ptosis. ln terms of cosmetic effect, levator muscle shortening surgery is better.

Objective To explore the diagnosis and Fogarty catheter embolectomy operation management of acute arterial embolism in the extremities.Methods The clinical data of 87 cases of acute arterial embolism in the extremities treated by Fogarty catheter was ana- lyzed retrospectively,Results All cases were diagnosed through asking patient history and symptom,physical examination and the check of color Doppler while the results were proved by operation.No one case received vasography.After operation,78 cases blood stream of limb had been resumed and cure rate of 87.6% was achieved while 4 cases improved(4.5%),and no occurrence of ischemic necrosis and amputated ex- tremity.5 cases(5.6%)received amputation at the relative level and there were 2 cases(2.3%)of perioperative death.Those cases who re- ceived operations within 48 hours from the time of morbidity achieved cure rate of 100%,while those cases more than 48 hours achieved cure rate of 47.6%,improvement rate of 19.0%,amputation rate of 23.8% and mortality of 9.6%.Conclusion First,Ultrasound Doppler exami- nation should be taken for avoidance of misdiagnosis when acute extremity arterial embolism is suspected.Second,The key Intraarterial embo- lectomy using Fogarty catheter is an effective method for the treatment of acute arterial embolism in the extremities,is significant in application,Third,as soon as the diagnosis is established,embolectomy with Forgarty catheter must be carried out to avoid clot extension and necrosis of the extremity.Satisfactory therapeutic efficacy can be got,if the patient receive operation within 48 hours from onset.

Objective To establish a method for the determination of methyl tertiary butyl ether (MTBE) in the cerebrospinal fluid of rats by gas chromatography and to know whether MTBE can penetrate the blood brain barrier. Methods 9 male SD rats were randomly divided into 3 groups and then exposed to MTBE by gavage at a dose of 1000 mg/kg?bw and by inhalation at a dose of 8 ml/L for 30 days. The cerebrospinal fluid was collected at 6 h, 12 h and 24 h respectively at the end of treatment and the MTBE in rats cerebrospinal fluid was determined by gas chromatography. Results MTBE was detected in the cerebrospinal fluid of rats after subchronic exposure of MTBE through gavage and inhalation. Conclusion MTBE is able to penetrate the blood brain barrier and reach the brain.

OBJECTIVETo explore the neuroprotective effect and mechanism of picroside II on extracellular regulated protein kinases1/2 (ERK1/2) signal transduction pathway in cerebral ischemia injuryrats. METHODS The middle cerebral artery occlusion (MCAO) model was established by inserting a monofilament into middle cerebral artery. Totally 96 successfully modeled Wistar rats were divided into the modelgroup, the treatment (picroside II) group, the Lipopolysachcaride (LPS) group, and the U0126 group according to random digit table. Each group was further divided into 3 subgroups, i.e. 6, 12, and 24 h sub-groups. Picroside II (20 mg/kg) was peritoneally injected to rats in the treatment group 2 h after ischemia.LPS (20 mg/kg) and Picroside II (20 mg/kg) were peritoneally injected to rats in the LPS group 2 h after ischemia. U0126-EtOH (20 mg/kg)and Picroside II (20 mg/kg) were peritoneally injected to rats in the U0126group 2 h after ischemia. Equal volume of normal saline was peritoneally injected to rats in the control groupand the model group. The neurobehavioral function was evaluated by modified neurological severity score(mNSS) test. The structure of neurons was observed using hematoxylin-eosinstaining (HE) staining. Theapoptotic cells were detected using terminal deoxynucleotidyl transferase dUTP nick end labeling (TUNEL) assay. The expression of phosphorylated extracellular signal-regulated protein kinase1,2 (pERK1,2) in cortex was detected using immunohistochemistry (IHC) and Western blot.

RESULTSAfter cerebral ischemia injury neurological impairment score increased, the damage of neuron in the cortical area was aggravated, apoptotic cells increased in the model group as time went by. The expression of pERK1/2 increased more significantly in the model group than in the control group (P <0.05). The damage of neuron in the cortical area was milder, while apoptotic cells decreased, the expression of pERK1f2 obviously decreased more in the treatment group and the U0126 group (P < 0.05). The early damage of neuron in the cortical area was more severe, apoptotic cells and the expression of pERK12 were comparatively higher in early stage of the LPS group, but the expression of pERK1/2 was somewhat decreased in late stage.

CONCLUSIONSActivating ERK12 pathway could mediate apoptosis and inflammatory reactions of neurons after cerebral ischemia injury. Picroside II could protect the nerve system possibly through reducing activation of ERKI2 pathway, inhibiting apoptosis of neurons and inflammation reaction.

Animals ; Apoptosis ; Brain Ischemia ; drug therapy ; Cinnamates ; pharmacology ; Infarction, Middle Cerebral Artery ; drug therapy ; Iridoid Glucosides ; pharmacology ; MAP Kinase Signaling System ; drug effects ; Neurons ; pathology ; Neuroprotective Agents ; pharmacology ; Random Allocation ; Rats ; Rats, Wistar

Background Pupil atresia increases the difficulty of cataract surgery.The improper enlarging pupil will lead to many complications.The appropriate method of pupil dilation is very important to improve the postoperative effect.Objective This study was to evaluate the pupillary function after manually enlarged pupil to different sizes for pupil atresia complicated cataract.Methods A retrospective case-controlled study was designed.Thirty-eight eyes of 30 cases suffered from pupil atresia complicated cataract induced by chronic uveitis were enrolled in Shandong Eye Institute from May 2006 to May 2012.The eyes underwent pupil forming and phacoemulsification and assigned to the pupil enlarged to ≥6.0 mm group (15 eyes) and 4.5-5.5 mm group (23 eyes).The fibrosis membrane at pupil zone was removed,and the fibrosis strip at pupil collar was cut evenly by 23G intraocular microscissors as zigzag shape.Then the pupil was enlarged in multipoint by a pair of left and right iris hook from the main and lateral incisions.The pupils of 15 eyes in the pupil enlarged to ≥6.0 mm group were dilated above 6.0 mm and 23 pupils in the 4.5-5.5 mm group were dilated to 4.5-5.5 mm and followed by routine phacoemulsification and foldable intraocular lens implantation.Topical and systemic corticosteroids and nonsteroidal anti-inflammatory drugs combined topical mydriatic were applied before and after operation.The pupil diameter,light reflex and photophobia symptom in postoperation were compared between the two groups.The visual acuity before and after operation and intra-and post-operative complications were recorded.This study was approved by Ethic Committee of Shandong Eye Hospital,and written informed consent was obtined from each patient before operation.Results The pupil diameter in the pupil enlarged to ≥6.0 mm group was dilated to (6.9±0.4) mm and that of the 4.5-5.5 mm was dilated to (5.1 ±0.3) mm intraoperatively,with a statistical significance between them (t =16.100,P =0.000).Three months later,the pupil diameter in the pupil enlarged to ≥ 6.0 mm group was (4.9 ±0.4)mm,with different degrees of lacerated pupillary margins,and that in the pupil enlarged to 4.5-5.5 mm group was (3.5 ±0.5) mm,with rare lacerated pupillary margins,showing a statistically significant difference (t =9.820,P =0.000).The unresponsive or obtuse light reflex in the pupil enlarged to ≥6.0 mm group was significantly higher than in the pupil enlarged to 4.5-5.5 mm group(11 eyes vs.6 eyes) (x2 =8.200,P =0.005).The subjective photophobia symptom of 2-3 grades in the pupil enlarged to ≥6.0 mm group was in 12 eyes,which was higher than that in the pupil enlarged to 4.5-5.5 mm group (2 eyes) (H=19.840,P=0.000).The iris haemorrhage were seen in 3 eyes in the pupil enlarged to 4.5-5.5 mm group and 7 eyes in the pupil enlarged to ≥6.0 mm group (x2 =5.290,P=0.030).The visual acuities of the operated eyes in the two groups improved at different degrees.Conclusions Approximate physiological pupil and good visual quality can been obtained by manual releasing and enlarging pupil to less than 5.5 mm evenly during the surgery for pupil atresia complicated cataract induced by chronic uveitis.

Background Eyes with filamentary keratitis present with serious clinical symptoms.This disease is easy to relapse and the treatment is tricky.At present,its pathogenesis is still unclear,and few works were done on filamentous composition.Objective This study was to analyze the composition of corneal filament by imageological and histopathological method,and discuss the formation mechanism of filamentary keratitis.Methods Eighty-eight eyes of 82 cases who suffered from filamentary keratitis were collected in Shandong Eye Hospital between January 2008 and January 2011.The etiologies of the patients were classified and the clinical data were recorded.Firstly,the corneal filiform strip was detected by laser scanning confocal microscopy (LSCM),and the corneal structure was examined by high-definition optical coherence tomography (HD-OCT).Then the composition of filamentary strip was analyzed by Giemsa and Masson trichrome staining of stretched preparation of filiform strip.Results Etiological study showed that filamentary keratitis occurred after penetrating keratoplasty in 40 eyes,after cataract surgery and photorefractive keratectomy (PRK) in 18 eyes,dry eye and neural dystrophic corneal disease in 14 eyes,acute conjunctivitis in 10 eyes.HD-OCT revealed that filament lesion developed to Bowman layer.Filament was composed of epithelial cells,inflammatory cells,mucus and the high reflective strip core with spiral arrangement under the LSCM,and epithelial cells,inflammatory cells and fibrous tissue were seen in the strip core.Giemsa staining exhibited that filament contained corneal epithelial cells,inflammatory cells,mucus and dark blued strip core with helical arrangement.Masson trichrome discovered that the strip core was red fibrous tissue surrounding by blue mucus.Conclusions Epithelial cells,inflammatory cells,mucus and the high reflective strip core with spiral arrangement are the main elements of filament in filamentary keratitis.The lesion can reach Bowman layer.The results contribute to reveal the formation mechanism of corneal filament and assist treatment.

Cell Line ; Embryonic Stem Cells ; Genetic Vectors ; Green Fluorescent Proteins ; genetics ; Humans ; Lentivirus ; genetics ; Transfection

BACKGROUND: Bag-1 is a multifunctional and anti-apoptotic gene. Its anti-apoptotic ability is enhanced when binding to bcl-2 to form a complex.Now it is considered as a predictive biomarker for the early diagnosis of breast cancer. However, whether it is useful in the assessment of the prognosis of breast cancer is still elusive.OBJECTIVE: To explore the expression of bag-1 in breast cancer and its role for prognosis.DESIGN: A controlled study with breast cancer, benign breast tumor and normal breast tissues as subjects.SETTING: The Vascular and Endocrine Surgery Department of Xijing Hospital of the Fourth Military Medical University of Chinese PLA.MATERIALS:Totally 100 breast cancer specimens were obtained form May 1995 to May 2000. Ten benign breast tumor and 10 normal breast tissues were used as control. All the specimens were paraffin-embedded and came from the Pathological Department of Xijing Hospital Affiliated to Fourth Military Medical University of Chinese PLA.METHODS: Immunohostochemical strept avidin-biotin complex(SABC) method was adopted to detect bag-1 expression in these specimens.pression levels of bag-1.RESULTS: The positive expression rate of bag-1 in breast cancer (85%) was significantly different form those of benign breast tumor (10%) and normal breast (10%) (χ2= 29.98, P = 0.00). While the positive expression rates in breast cancer of different stages (stage Ⅰ, stage Ⅱ and stage Ⅲ ) were 88%, 82% and 88%, respectively, which has no significant difference (χ2 = 0. 61, P = 0.75) . In duct carcinoma, lobular carcinoma and special carcinoma, bag-1 positive expression rate was 86%, 85% and 80%,which was also no significantly different (χ2 =0.16, P =0.95). In the 94followed patients, the 5-year survival rate of positive bag-1 expression was 79% and that of negative bag-1 expression was just 9%. The difference was significant (χ2 = 0. 07, P = 0.04).CONCLUSION: High bag-1 expression exists in breast cancer and its level is not associated with the clinical stages or pathological types of the cancer.Therefore, bag-1 may be used as a predictive marker for the prognosis of breast cancer.