简介:目的:构建表达小鼠CD4+T细胞钙支架蛋白AHNAK1的短发夹RNA(shorthairpinRNA,shRNA)慢病毒载体,并研究其对小鼠甲状腺相关性眼病(thyroid-associatedophthalmopathy,TAO)的抑制效应。方法:设计并筛选对AHNAK1具有良好干扰效力的shRNA序列,慢病毒载体包装干扰序列,感染小鼠CD4+T细胞,检测AHNAK1静默对T细胞功能的抑制作用,采用实验动物模型观察AHNAK1体内抑制甲状腺相关性眼病的效果。结果:成功筛选出具有良好干扰效力的shRNA,并包装入慢病毒。病毒滴度为1.0伊106TU/mL,转染慢病毒的CD4+T细胞展现出失能倾向,抑制炎症免疫反应;在动物模型中抑制T细胞中AHNAK1表达可以有效控制甲状腺眼病的发生发展,显著降低治疗组T细胞中IL-2、IL-1茁和IFN-酌的表达。结论:成功构建了表达小鼠AHNAK1shRNA的慢病毒,具有抑制T细胞分泌IL-2、IL-1茁和IFN-酌的表达效应,能够有效抑制甲状腺眼病的发生发展。
简介:AIM:ToanalyzecasesofobstructionofthenasolacrimalductwhichcreatesafertileenvironmentforsecondarybacterialInfectionandcanresultindacryocystitis,whichisaconstantthreattocorneaandorbitalsofttissueandapotentialsourceofendophthalmitisfollowingintraocularsurgery.Themajorityofobstructionsofthelacrimalexcretoryoutflowsystemareacquiredonesoccurringinadulthoodandinvolvingthedistalpartsofthesystem.Acquiredobstructionmaybeprimary/idiopathicorsecondarytoawidevarietyofinfectious,inflammatory,traumatic,mechanical,toxicorneoplasticcausesmimickingidiopathicinflammation.Thesecasesaretreatedbydacryocystorhinostomy(DCR).METHODS:Thepresentstudywasconductedtodeterminethehistopathologic,immunohistochemicalandcurrentmicrobiologiccharacteristicsoflacrimalsacspecimensinpatientsundergoingexternaldacryocystorhinostomy.RESULTS:Non-specificlacrimalsacpathologywaspresentinall33casesand81.8%ofthecasesshowedmoderatechronicinflammationwithachronicinflammatoryscore(CIS)rangingbetween4and6,whereas12.12%showedsevereinflammatorychangeswithaCISof7.Milddegreeofinflammationwasseenin6.06%withaCISof3.Thetotalprevalenceofgrampositive,gram-negative,andculture-negativesampleswere59.4%,37.5%,and3%respectively.CONCLUSION:Non-specificchronicinflammationwithfibrosisisindeedthemostcommonlyreportedhistopathologicalfindinginlacrimalsacwallbiopsyspecimens.
简介:目的:探讨单侧内直肌截除术治疗儿童残余性和复发性外斜视的有效性及安全性,评价其在不同外斜视类型及不同初次手术方式应用的差异性。方法:回顾性病例系列研究。收集2009-01/2013-02在山东大学附属山东省立医院行单侧内直肌截除术治疗的残余性和复发性外斜视连续性病例48例48眼,观察术后第Id,6wk以及末次随访(术后6~32mo)时患儿眼位、眼位非共同性、融合功能及立体视锐度情况。结果:术后第Id手术正位率为83%(40/48),欠矫率为4%(2/48),过矫率为13%(6/48);术后第6wk手术正位率为81%(39/48),欠矫率为13%(6/48),过矫率为6%(3/48);末次随访时正位率为75%(36/48),欠矫率为25%(12/48),无1例过矫。不同初次手术方式和不同外斜视类型患儿末次随访时手术正位率的差异均无统计学意义(P=0.168、0.50)。术后所有病例均未出现眼球运动非共同性和眼球外转受限。结论:单侧内直肌截除术是治疗儿童残余性和复发性外斜视的安全有效术式,其在不同外斜视类型及不同初次手术方式应用的疗效无差异。
简介:AIM:Tofindouttheoutcomeoflaserphotocoagulationinclinicallysignificantmacularedema(CSME)byopticalcoherencetomography(OCT).·METHODS:Itwasaprospective,non-controlled,caseseriesstudyenrolling81eyesof64patientswithCSMEbetweenAugust2008andJanuary2010.AllpatientsreceivedmodifiedgridphotocoagulationwithfrequencydoubledNd:YAGlaser.Eachpatientwasevaluatedintermsofbest-correctedvisualacuity(BCVA)andregressionorprogressionofmaculopathyafterlasertherapyat1,3and6months.Spearman’scorrelationtestwasusedtoshowthecorrelationbetweenBCVAandtotalmacularvolume(TMV).Analysisofvariance(ANOVA)wasusedtocompareamonggroupsandindependentt-testwasusedtocompareineachgroup.·RESULTS:ThereishighcorrelationbetweenBCVAandTMV(P≤0.001).BCVAimprovedin50.6%,remainedstaticin39.5%anddeterioratedin9.9%patientsafter6monthoftreatment.TheBaselineTMV(meanandSD)were9.26±1.83,10.4±2.38,11.5±3.05,8.89±0.75and9.47±1.98mm3fordifferentOCTpatterns,ST(spongelikethickening),CMO(cystoidmacularedema),SFD(subfovealdetachment),VMIA(Vitreomacularinterfaceabnormality)andaverageTMVrespectively(P=0.04).After6monthsoflasertreatment,themeanTMVdecreasedfrom9.47±1.98mm3to8.77±1.31mm3(P=0.01).InSTtherewassignificantdecreaseinTMV,P=0.01,Furtherwithinthesegroupsat6months,theyweresignificantlydifferent,P=0.01.·CONCLUSION:OCTshowedthedifferentmorphologicalvariantofCSMEwhiletheresponseoftreatmentisdifferent.TMVdecreasedthemostandhenceshowedtheimprovementinvisionafter6monthsoflasertreatment.IntheeraofAntivascularendothelialgrowthfactors(VEGFs),efficacyoflaserseemstobeinshadowbutitisstillfirstlineoftreatmentindevelopingnationlikeNepalwhereantiVEGFsmaynotbeeasilyavailableandaffordable.
简介:目的:观察视网膜视盘周围视网膜神经纤维层(retinanervefiberlayer,RNFL)厚度和神经节细胞复合体(ganglioncellcomplex,GCC)厚度对慢性原发性闭角型青光眼(chronicprimaryangle-closureglaucoma,CPACG)的诊断价值,研究其和平均视野缺损(MD)的相关性。方法:选取早期CPACG患者21例38眼,疑似青光眼(suspectedglaucoma,SG)患者25例46眼和正常对照25例49眼进行SD-OCT检查,测量平均及各个象限的RNFL厚度和GCC厚度,分析RNFL厚度和GCC厚度与视野MD的相关性。结果:CPACG组的平均和各象限RNFL厚度和GCC厚度与正常对照存在显著性差异(P〈0.01),与SG组比较,平均及上方(P〈0.01)、下方(P〈0.05)RNFL厚度存在显著性差异,平均和各象限GCC厚度存在显著性差异(P〈0.01)。CPACG组RNFL(r=0.65)、GCC(r=0.72)均与MD呈明显的正相关。结论:RNFL厚度和GCC厚度对早期CPACG的诊断和病情监测中具有临床价值,GCC厚度的临床意义可能更佳。
简介:·Thisisacasepresentationofaverybizarreopenglobetraumawithanteriorsegmentforeignbody-fishinghookstuckinthecorneaandiris.Complicationsduetothiskindofeyetraumamightbeveryhazardousandwithseriousimpactonvisualfunction.Wearerepresentingourapproachandexperienceofthreestepmanagementofthiskindofeyeinjury:first-extracttheforeignbody,closeandreconstructtheeyeball,second-fightinflammation,andthird-restorethevisualfunctionbycataractsurgery.·
简介:AIM:ToevaluatethecornealendothelialcelldensityandmorphologyinChinesepatientswithpseudoexfoliationsyndrome(PEX).·METHODS:Medicalrecordsof16patients(20eyes)withPEXwhopresentedtoourinstitutionbetweenJuly2008andJune2010wereretrospectivelyreviewed.Thirteeneyeshadcombinedglaucoma.Theinformationoffiveapparentlynormalfelloweyesinthesepatientswasalsorecorded.Lefteyesof20patientswithbilateralsenilecataractsbutnoothereyediseasewereincludedascontrols.Specularmicroscopywasperformedinalleyestoanalyzeforcornealendothelialcelldensityandmorphology.Celldensity,coefficientofvariationincellsize,andpercentageofhexagonalcellsincornealendotheliumwereevaluated.·RESULTS:ThemeancornealendothelialcelldensityinthePEXeyeswas2298±239cells/mm2,significantlylowerthanthatinthecataracteyes(2652±18cells/mm2,P=0.026),buttherewerenosignificantdifferencesincoefficientofvariationofcellsizeandfrequencyofhexagonalitybetweenthesetwogroups.NosignificantdifferencesinthethreeparameterswerefoundbetweentheapparentlynormalfelloweyesandthePEXeyesorthecataracteyes,orbetweenthePEXeyeswithandwithoutglaucoma.·CONCLUSION:CornealendothelialcelldensitymaydecreaseinChinesepatientswithPEX.ThedevelopmentofglaucomainPEXeyesdoesnotseemtoberelatedwiththechangeincornealendothelialcelldensityormorphology.
简介:目的:系统评价拉坦前列素(Latanoprost)滴眼液与噻吗心安(Timolol)滴眼液降眼压的有效性和安全性。方法:计算机检索PubMed,Medline,CNKI及中国生物医学文献数据库收录的,并辅以手工检索、因特网搜索的有关拉坦前列素与噻吗心安治疗原发性开角型青光眼和高眼压症的随机对照试验(RCT)。按照纳入和排除标准限定研究对象,通过Jadad评分量表进行文献质量评估后,针对眼压下降比例、药物不良反应2项内容,使用Cochrane协作网提供的RevMan5.0软件进行Meta分析。结果:共纳入9项RCT,合计555例患者。Meta分析结果显示:(1)拉坦前列素滴眼液与噻吗心安滴眼液降眼压效果,在2,6,12wk时差异均有统计学意义(P<0.01),加权平均差(WMD)分别为:在2wk[WMD=-0.76,95%CI(-1.32,-0.20)],在6wk[WMD=-1.15,95%CI(-1.68,0.63)]和12wk[WMD=-1.01,95%CI(-1.42,-0.61)]。(2)随访结束时,结膜充血、异物感为拉坦前列素的两种较为常见的不良反应,但其发生率拉坦前列素组与噻吗心安组比较,结膜充血的发生率[OR=2.25,95%CI(0.99,5.08)],异物感的发生率[OR=2.48,95%CI(1.02,6.03)],显示二者差异均无统计学意义。结论:治疗原发性开角型青光眼和高眼压症,拉坦前列素降眼压效果在用药12wk内较噻吗心安好;两者在12wk内引起结膜充血、异物感、虹膜色素加深、视野损害等的不良反应方面,差异不明显。由于纳入研究的样本量偏小,且方法学质量中等,致使本系统评价结果论证强度不高,因此还需要开展更多的高质量的临床随机对照研究,以便更客观、准确、全面地评价其疗效和安全性。
简介:研究显示,趋化因子受体3(chemokinereceptor3,CCR3)在眼部主要分布于视网膜色素上皮细胞中,亦表达于脉络膜血管内皮细胞(CECs)中。CCR3的特异性高表达在湿性年龄相关性黄斑变性(age-relatedmaculardegeneration,AMD)中被发现,并被证明在湿性AMD患者脉络膜新生血管(choroidalneovascularization,CNV)的产生中具有重要作用。本文拟对CCR3的结构、功能、目前研究存在的问题及未来的研究方向做一综述。相信随着对CCR3研究的进一步深入,必将帮助我们寻找到一种湿性AMD诊断和治疗的新方法,同时也可能对其它CNV性疾病研究以及新的抗CNV药物提供重要参考。
简介:·AIM:Toexploretheeffectofimmunizationwithcopolymer-1(COP-1)andretinalstemcells(RSCs)transplantationoninterferon-gamma(IFN-γ)levelsinaratexperimentalglaucomamodel.·METHODS:Anexperimentalglaucomawasinducedbyargonlaserphotocoagulationoftheepiscleralveinsandlimbalplexusintherighteyeofrats.Immediatelyfollowingglaucomainduction,ratswereimmunizedwithCOP-1.RSCswereculturedandtransplantedintravitreallyintotheeyesofglaucomamodelanimals1weekpost-lasertreatment.Sixexperimentalgroupswereused:COP-1/RSC,PBS/RSC,COP-1/PBS,PBS/PBS,glaucomamodelgroup,andanormalcontrolgroup.TheconcentrationofIFN-γinaqueoushumor(AH)andserumwasmeasuredbyenzyme-linkedimmunosorbentassay(ELISA)ineachofthesixgroups.Retinalganglioncell(RGC)survivalwasassessedbyquantifyingapoptosisusingHoechststaining.·RESULTS:ConcentrationsofIFN-γinAHandserumofratsthathadundergoneglaucomainductionwerehigherthanthoseofnon-inducedcontrolrats.TheconcentrationsofIFN-γinAHandserumoftheCOP-1/RSCstreatedgroupweredeterminedtobe2371.9ng/Land710.9ng/L,respectively,whichweresignificantlylowerthanthoseintheothertreatedgroups(P<0.05).Infact,IFN-γlevelsinthedualtreatedgroupwerereducedtobackgroundlevels.TheCOP-1/RSCgrouphadlowernumberofapoptoticRGCsthantheotherthreeexperimentalgroups(P<0.05).·CONCLUSION:ThereducedlevelsofIFN-γinAHandserumoftheCOP-1/RSCgroupmayberelatedtosynergisticeffectsbetweenRSCstransplantationandCOP-1immunemodulation.ItislikelythatthelowerlevelsofIFN-γpreventedRGCsglaucomatousapoptosis.·
简介:目的:探讨高度近视黄斑病变的光学相干断层扫描(OCT)和眼底荧光血管造影(FFA)的形态学特征、分类和对比分析。方法:对入选的高度近视黄斑病变患者61例101眼均行标准对数视力表检查,验光确定屈光度及最佳矫正视力(BCVA),并用IOL-Master测量眼轴长度。入选者需在同一天内行散瞳眼底检查、OCT及FFA检查,必要时行眼底联合造影(FFA&ICGA)。分析不同类型的OCT及FFA形态学特征之间的相互联系,并探讨其与屈光度、最佳矫正视力、眼轴长度及中心凹厚度之间的关系。结果:FFA分类的漆样裂纹型在OCT分类的1型中所占比例为57.14%,显著高于新生血管型和黄斑萎缩型(21.43%),差异有统计学意义(P<0.05)。FFA分类的黄斑萎缩型在OCT分类的2型中所占的比例为67.80%,显著高于漆样裂纹型(18.64%)和新生血管型(13.56%),差异有统计学意义(P<0.05)。OCT3型均属于FFA分类的黄斑萎缩型。OCT1型的屈光度、眼轴长度明显低于2型和3型,而最佳矫正视力和中心凹厚度则明显高于2型和3型。FFA的漆样裂纹型与新生血管型在屈光度及眼轴长度上虽无明显差异,但后者的BCVA及中心凹厚度显著低于前者(P<0.05)。漆样裂纹型及新生血管型的屈光度、眼轴长度均显著低于黄斑萎缩型,最佳矫正视力则明显高于黄斑萎缩型(P<0.05)。结论:高度近视黄斑病变的OCT和FFA形态学特征密切相关,结合OCT和FFA的图像特征对高度近视黄斑病变形态学改变进行对比分析,不仅有助于明确病变的性质,提高我们对疾病发病机制及预后转归的认识,更为临床诊疗提供了有力的支持。
简介:目的探讨前房注入1%利多卡因作为表面麻醉的一种辅助麻醉在眼前段内眼手术中的麻醉效果.方法对29例42眼患者眼前段内眼手术,在手术进入前房前,通过1mm前房穿刺或侧切口注入1%利多卡因,观察麻醉效果及术中术后并发症.结果Ⅰ级手术中完全无疼痛,手术配合良好;Ⅱ级术中疼痛轻微,可以耐受配合手术完成;Ⅲ级术中疼痛较剧,难以忍受.Ⅰ级者40眼,Ⅱ级者2眼,Ⅲ级者0眼,术中、术后无出现并发症.结论表面麻醉联合前房注入1%利多卡因是一种安全、有效、并发症少的麻醉方法.
简介:AIM:ToinvestigatetheeffectofY-27632onthesurvivalandneuriteoutgrowthoftheculturedretinalneurocytes.METHODS:Afterthepostnatalday2-3,Sprague-Dawleyretinalneurocyteswereculturedfor48hours,theculturemediawasreplacedwithserum-freemedia(controlgroup)andserum-freemediacontained30μmol/LY-27632(Y-27632group),andthecellswerecontinuallyculturedanother48hours.Theculturedretinalneurocyteswereidentifiedwithanti-neuronspecificenolase(NSE)immunocytochemistry.ThesurvivalstateofthosecellswasestimatedbyMTTassay,andtheneuriteoutgrowthofthosecellswasevaluatedbythecomputerizedimage-analysissystem.RESULTS:Comparedwiththecontrolgroup,theabsorbancevaluesofcellssurvivalinY-27632groupincreased12.90%and33.33%respectivelyafter72and96hoursculture.Y-27632hadnosignificanteffectonthediameterofculturedretinalneurocytes.Comparedwiththecontrolgroup,Y-27632inducedastableimprovementofneuriteoutgrowthofretinalneurocytesafter72and96hoursculture(P=0.001).CONCLUSION:Y-27632couldpromotethesurvivalandneuriteoutgrowthoftheearlypostnatalculturedretinalneurocytes.