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Objective:To study the expression and value of inflammatory factors and disease activity in dry eyes of rheumatoid arthritis patients.Methods:From March 2017 to November 2019, 78 patients with rheumatoid arthritis complicated with dry eye diagnosed by the rheumatology department of our hospital, 80 patients with simple dry eye treated in the ophthalmology clinic and 80 normal volunteers were collected. All subjects were examined for OSDI questionnaire scores, tear film rupture time (BUT), tear secretion test (SIT), and corneal fluorescein staining (FL) scores. Erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), rheumatoid factor (RF) and other disease activity-related indicators were collected. The concentrations of interleukin-1b (il-1b), tumor necrosis factor-a (tnf-a), chemokine 3(CCL3), CCL4, CCL5, and vascular endothelial growth factor (VEGF) in the collected tears were detected by double-antibody sandwich enzyme-linked immunosorbent assay (ELISA). One-way Anova was used to analyze the correlative indexes among the three groups, LSD- t method was used for multiple comparison. Pearson's method was used to analyze the correlation between Ra activity and dry eye. Results:The results of OSDI [(44±9) points vs (44±9) points vs (24±7) points], SIT [(3.3±2.2) mm/5 min vs (3.6±2.1) mm/5 min vs (11.7±1.6) mm/5 min], BUT [(4.3±1.8) s vs (5.9±1.9) s vs (10.4±2.0) s], FL [(7.3±3.1) points vs (5.7±2.8) points vs (1.6±1.6) points] were com-pared among the three groups. There were significant differences among the three groups( F=154.22, P<0.01; F=470.49, P<0.01; F=217.72, P<0.01; F=101.99, P<0.01). The concentrations of IL-1β [(1.92±0.14) ng/L vs (1.28±0.18) ng/L vs (0.64±0.15) ng/L], IL-6 [(38.24±0.69) ng/L vs (36.31±0.82) ng/L vs (30.43±0.87) ng/L]、TNF-α [(0.78±0.03) ng/L vs (0.67±0.03) ng/L vs (0.56±0.02) ng/L], CCL3 [(91±25) ng/L vs (83±21) ng/L vs (24±18) ng/L], CCL4 [(187±76) ng/L vs (137±64) ng/L vs (37±5) ng/L], CCL5[(259±70) ng/L vs (182±42) ng/L vs (135±34) ng/L] and VEGF [(172±25) ng/L vs (152±22) ng/L vs (41±21) ng/L] in the tears of the three groups were significantly different( F=1 300.15, P<0.01; F=2 036.37, P<0.01; F=1 305.89, P<0.01; F=764.01, P<0.01; F=225.47, P<0.01; F=138.48, P<0.01; F=121.04, P<0.01). The indexes of disease activity (ESR, CRP, RF) were compared among the three groups. The positive rate of RF[(100%) vs (5%) vs (4%)] was significantly higher in Ra dry eye group than in the other two groups ( χ2=127.38, P<0.01) There were significant differences in ESR[(51±23) mm/1 h vs (9±4) mm/1 h vs (8±5) mm/1 h] and CRP[(44±23) g/L vs (5±4) g/L vs (6±4) g/L] among the three groups ( F=253.18, P<0.01; F=222.36, P<0.01) . BUT was negatively correlated with the activity index (ESR, CRP, RF) in rheumatoid arthritis dry eye group ( r=-0.398, P=0.005; r=-0.353, P=0.010; r=-0.302, P=0.038) , FL was positively correlated with activity index (ESR, CRP, RF) ( r=0.345, P=0.014; r=0.385, P=0.007; r=0.412, P=0.003) . There was no correlation between SIT, OSDI and activity index (ESR, CRP, RF)( r=-0.265, P=0.060; r=-0.156, P=0.318; r=-0.275, P=0.070); ( r=-0.087, P=0.582、 r=-0.065, P=0.664; r=-0.045, P=0.768). Conclusion:Inflammatory factors and disease activity indexes are highly expressed in rheumatoid arthritis patients with dry eye of disease, and there is a correlation between disease activity of rheumatoid arthritis and dry eye, which has some clinical meaing.
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Background The study on eye surface damage following phacoemulsification with intraocular lens (IOL) implantation is increasingly concerned,and these symptoms were associated with dry eye and often treated by polyethylene glycol eyedrops to remit the discomfortableness.Recombinant bovine basic fibroblast growth factor (rb-bFGF) eyedrops contains neurotrophic factors, but its effect on eye surface damage is worth researching.Objective This study was to evaluate the repair effects of rb-bFGF on ocular surface injury after phacoemulsification with IOL implantation.Methods A randomized controlled trail was designed.Ninety eyes of 72 consecutive patients with age-related cataract were enrolled in Fenyang Hospital of Shanxi Province from September 2010 to August 2013 under the informed consent.Phacoemulsification with IOL implantation was performed on all the eyes, and tobramycin and dexamethasone eye drops was used for 15 days as basis therapy.According to the treatment sequence,the operative eyes were assigned to rb-bFGF eyedrops group, polyethylene glycol eyedrops group and basis therapy group.rb-bFGF drops and polyethylene glycol drops were topically administered 4 times per day since the first day after surgery for consecutive 30 days in corresponding group,and only basis therapy was maintained in the basis therapy grouply.Corneal fluorescence (FL) staining scores,breakup time of tear film (BUT) and Schirmer Ⅰ test (S Ⅰ t) without topical anesthesia were examined in 1 day before operation and 1 day,7 days, 15 days and 30 days after operation.The efficacy was intergrouply compared.Results No significant differences were seen in the demography and the relevant surface examinational outcomes among the rb-bFGF group, polyethylene glycol drops group and the basis therapy group before surgery (age : F =1.50;gender :x2 =0.336, both at ＞ 0.05;FL : F =0.31;BUT:F =0.65;S Ⅰ t: F =0.57;all at P ＞ 0.05).Compared with the before operation, FL scores were obviously increased,and BUT values were reduced and S Ⅰ t values were elavated in all the eyes early stage of surgey and then gradually improved with the lapse of postoperative time, showing significant differences (Ftime =7.83,7.32,7.17, all at P＜0.01).The FL scores,BUT and S Ⅰ t in 15 days after surgery in the rb-bFGF drops group and 30 days after surgery in the polyethylene glycol drops group was closed to those of before surgery (all at P＞0.05).However,there were still significant differences between the before and after operation in the basis were closed to those of before surgery therapy group (all at P＜0.05).In addition, significant differences were found in corneal FL scores, BUT and S Ⅰ t among these three groups (Fgroup =5.08,4.15,4.61, all at P＜0.05).In postoperative 15 days and 30 days, the S Ⅰ t values were (12.32±1.18) and (11.32±1.98) mm/5 rmin,which were significantly lower than (14.36±1.77) and (13.36±2.32) mm/5 min in the polyethylene glycol drops group and (17.25 ±2.24) and (13.25 ±2.53) mm/5 min in the basis therapy group (all at P ＜ 0.05).Conclusions The topical application of rb-bFGF combined with tobramycin and dexamethasone eyedrops can improve the dry eye-related symptoms and promote the repair of the ocular surface injury after phacoemulsification with IOL implantation,and the clinical efficacy of rb-bFGF eyedrops is better than that of polyethylene glycol eyedrops or only tobramycin and dexamethasone eyedrops.
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Objective To investigate the efficacy of pranoprofen drops on dry eye of patients with Sj(o)gren's syndrome (SS).Methods This is a prospective study.Sixty-eight inpatients with dry eye in our hospital were randomly divided into the experimental and control groups.Right eyes were taken for the trial,with 34 cases in each group.The experimental group was given pranoprofen eye drops combined with polyethylene glycol eye drops.Eyes of the control group were given polyethylene glycol drops only.Corneal fluorescein staining (FL),tear film breakup time (BUT) and Schirmer test (SIT) were tested before treatment and 1,2,4 weeks after treatment by the same care giver.The levels of IL-6 and TNF-α in tears were detected by ELISA.Analysis of variance of repeated data and t test were used for statistical analysis.Results The difference of FL,BUT,SIT and content IL-6 and TNF-α in tears in the experimental group patients before treatment and 1,2,4 weeks after treatment were signifcant (F=4.65,7.53,6.43,9.96,10.87; P＜0.05),which were statistically significantly different between the experimental group and the control group patients (F=3.27,5.85,4.36,8.36,7.23; P＜0.05).One week after treatment and before treatment,the difference of BUT and SIT of the two groups was not statistically significant (P＞0.05),those of the 2 weeks after treatment were statistically significantly different [BUT of the experimental group was (11.1±2.5) s,BUT of the control group was (9.7±1.9) s,t=2.594 8,P＜0.05; the SIT of the experimental group was (7.3±1.7) mm,the SIT of the control group was (5.9±1.7) mm,t=3.571 8,P＜0.05].BUT of the two groups at 4 weeks after treatment was statistically significantly different [BUT of the experimental group was (14.4±2.8) s,BUT of the control group was (11.4±2.6) s,t=4.469 4,P＜0.05; the SIT of the experimental group was (9.9±2.1) mm,the SIT of the control group was (8.7±1.9) mm,t=2.568 0,P＜0.05].The difference of FL and IL-6 and TNF-α in tears pretreatment between the two groups was not statistically significant (P＞0.05).At week 1,2,4 after treatment,the differences between the two groups were statistically significant (tFL=4.173 9,3.190 7,4.072 6; tIL-6=2.131 5,2.316 4,5.310 1; tTNF-α=2.216 4,4.871 9,8.175 0; P＜0.05).No significant discomfort and side effects were observed in the two groups.Conclusion Pranoprofen drops can significantly improve symptoms of dry eye in patients with pSS,in particular,the repair of the cornea,may be related to the inhibition of the expression of ocular inflammatory cytokines IL-6 and TNF-α,and thus reduce the ocular surface inflammatory reaction.
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Objective To investigate the surgery timing for patients with intermittent exotropia.Methods Far and near stereopsis of 36 patients with intermittent exotropia were measured preoperative and postoperative six months respectively,and the results were analyzed.Results Near stereopsis were measured preoperative in 30 cases (83.3％,30/36) with intermittent exotropia.But far stereopsis were measured preoperative in 7 cases (19.4％,7/36) with intermiuent exotropia.There was statistic significance (P ＜0.05).Near stereopsis were measured preoperative in 30 cases (83.3％,30/36) with intermittent exotropia and postoperative in 35 cases (97.2％,35/36).There was statistic significance (P＜0.05).Far stereopsis were measured preoperative in 7 cases (19.4％,7/36) with intermittent exotropia and postoperative in 14 cases (38.9％,14/36).There was statistic significance (P＜ 0.05).Conclusions Far stereopsis would be an important factor to choice the surgery timing for patients with intermittent exotropia.Operation is beneficial to restore far and near stereopsis.