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@#Artificial intelligence is described as the“fourth industrial revolution”. Driven by the development of the Internet and big data, ophthalmology has become a frontier discipline in this wave, showing a good prospect of vigorous development. Artificial intelligence has been applied to the auxiliary screening, diagnosis and treatment of a variety of eye diseases, and assisted in the completion of corneal, refractive, cataract and other related operations; Help realize graded diagnosis and treatment, telemedicine and improve the training mode of ophthalmic talents, and participate in eye health management and ophthalmic education. While artificial intelligence brings benefits to mankind, it also brings a number of ethical problems, among which the contradictions related to medical ethics, such as the division of responsibility for diagnosis and treatment errors, the protection of patient information privacy, humanistic care and its fairness, the contradiction between the growing artificial intelligence and imperfect ethics and laws are particularly prominent. Artificial intelligence must be guided by the correct value and abide by the corresponding ethical norms to continue to mature and improve in clinical practice. This paper summarizes the development status and ethical dilemma of ophthalmology under the background of artificial intelligence to provide reference for promoting its healthy development in the field of ophthalmology.
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@#AIM: To observe the curative effect of pterygium resection and autologous limbal stem cell transplantation(LSCT)combined with amniotic membrane transplantation(AMT)in the treatment of pterygium.<p>METHODS: Totally 177 patients(187 eyes)with pterygium treated in ophthalmology clinic of the hospital between January 2017 and January 2020 were selected and randomly divided into group A(59 cases, 64 eyes), group B(59 cases, 60 eyes), and group C(59 cases, 63 eyes). All were treated with pterygium resection. On this basis, patients in the three groups were treated with autologous LSCT, AMT, and autologous LSCT combined with AMT, respectively. All subjects were followed up for 12mo after surgery. Visual acuity, corneal epithelial repair, and neovascularization of the three groups were comparatively analyzed. Postoperative recurrence rate, ocular symptoms, complications, and survival of grafts were statistically analyzed.<p>RESULTS: Visual acuity changes and repair time of corneal epithelial defect showed no statistically significant difference among the three groups(<i>P</i>>0.05). 1mo after surgery, the corneal fluorescein staining(FL)value of group C was significantly lower than that of group A or group B(all <i>P</i><0.05). No angiogenesis or recurrent true pterygium was observed. 6mo and 12mo after surgery, the grades of conjunctival fibroplasia in group A and group C were significantly different from that in group B(<i>P</i><0.05). There was no statistically significant difference in the wet length of the filter paper in Schirmer I test in terms of time, inter-group and interaction effects(<i>P</i>>0.05). 1mo after surgery, the tear film breakup time(BUT)of group C was significantly longer than that of group A or group B(all <i>P</i><0.05). There were different degrees of conjunctival edema in the three groups after surgery, which disappeared within 2wk after suture removal. Grafts all survived, vascularization of amniotic membrane grafts ended.<p>CONCLUSION:Autologous LSCT, AMT and autologous LSCT combined with AMT all are effective in the treatment of pterygium. However, autologous LSCT combined with AMT can achieve better short-term effect, with milder conjunctival fibroplasia and dry eye symptoms.
ABSTRACT
Objective To explore the effects of estradiol on the telomerase activity and apoptosis of lens epithelial cells and its mechanisms.Methods Fifty adult female Sprague-Dawley rats were randomly divided into five groups (n =10):ovariectomized group,estradiol group 1,estradiol group 2,estradiol group 3 and sham group.All rats were prepared for ovariectomized models except that of the sham group.After 2 weeks of the operation,rats in the 5 groups were given naphthalene solution through a stomach tube,and meanwhile,estradiol group 1,estradiol group 2,estradiol group 3 received estradiol valerate with the dose of 0.21 mg · kg-1 · d-1,0.42 mg · kg-1 · d-1 and 0.84 mg · kg-1 · d-1,accordingly,while rats in the ovariectomized group and sham group were given 9 g · L-1 Nacl by stomach perfusion with a dose of 0.42 mg · kg-1 ·d-1.Then,the opacity of the lens in each group was examined by a slit lamp microscope every week.After 12 weeks of naphthalene solution administration,all rats were sacririced and the serum estradiol concentration was determined by radioimmunoassay.Next,the lenses were taken out,and TERT mRNA expression of lens epithelial cells (LEC) was measured by RT-qPCR,and finally,the apoptotic rate was detected by TUNEL method.Results The opacity of lens in the ovariectomized group was different from that in the estradiol group 1,estradiol group 2,estradiol group 3 and sham group,with statistical significances (all P ＜ 0.05),and the opacity of lens in the estradiol group 1,2,3 and sham group were mild and occurred later.The serum estradiol concentration in the ovariectomized group (8.19 ± 1.45)ng · L-1 was significantly lower than that of estradiol groupl,2,3 and sham group,and there were significant differences (all P ＜ 0.05).Thc relative expression of TERT mRNA in LEC in the ovariectomized group (0.371 2-±0.056 4) was significantly lower than that in estradiol group 1,2,3,but the apoptotic rate of LEC (0.602 1 ±0.010 8) was obviously higher than that of estradiol group 1,2,3 in a dose-dependent manner,and there were significant differences (all P ＜ 0.05).Pearson correlation analysis showed the relative expression of LEC TERT mRNA in rats was negatively correlated with the apoptosis rate(r =-0.859,P ＜ 0.05).Conclusion Estradiol can up-regulate TERT mRNA expression and enhance telomerase activity of LEC in naphthalene-induced ovariectomized female rats in a dose-dependent manner.Estradiol can inhibit the LEC apoptosis in naphthalene-induced ovariectomized female rats,and the mechanism may be related to the increase of telomerase activity in the LEC.