Foxp3,Galectin-9,PD-L1在小鼠DC2.4细胞的表达

目的观察CD80,CD86,Foxp3,Galectin-9,PD-L1在小鼠DC细胞的表达,了解小鼠DC2.4细胞系的免疫学特性。方法用含10%胎牛血清的RPMI-1640培养液培养小鼠DC2.4细胞,光学显微镜观察细胞形态;流式细胞术检测CD80,CD86,Foxp3,Galectin-9,PD-L1在DC2.4细胞表达。结果光学显微镜示小鼠DC2.4细胞贴壁生长,呈树突、梭形及不规则形;流式细胞术检测DC2.4细胞CD80表达为91.04%±4.90%,CD86表达为98.54%±1.96%,Foxp3无或微表达,Galectin-9表达为14.33%±2.94%,PD-L1表达为98.80%±0.63%。结论小鼠DC2.4细胞是一个高表达CD80,CD86及PD-L1,低表达Galectin-9,无或微表达Foxp3的细胞系。     

自体角膜为载体Boston人工角膜治疗复杂性角膜盲

目的评价复杂性角膜混浊患者使用自体角膜做载体的BostonI型人工角膜植入的临床效果。方法回顾性病例研究。10例角膜盲患者（10眼）,术眼病变严重,经至少2名以上国内著名角膜病专家会诊。无法通过角膜移植复明。其中严重碱烧伤7眼,爆炸伤1眼,角膜内皮失代偿多次角膜移植失败1眼．双眼病毒性角膜炎角膜严重血管化1眼。其中9例为双眼盲。术前视力光感或手动。所有病例均一期完成手术,术中使用8．0mm或8．5mm环钻钻取患者角膜,用患者混浊病变的角膜为载体。安装Boston人工角膜。形成患者角膜．人工角膜复合体,复合体作为植片如传统角膜移植实行角膜植床和植片缝合固定,术中常规行晶状体摘除术。结果术后观察1-12个月,平均（5．7±3．8）个月,除1眼视力光感外,其余裸眼视力为0．1～0．8。手术并发症包括角膜植床出血人玻璃体腔2例,继发性青光眼2例,人工角膜后膜4例。所有术眼均无术后漏水并发症发生。结论人工角膜特别适合于穿透性角膜移植难于成功的角膜盲患者,而且是目前对严重角膜瘢痕血管化、眼睑或泪液功能不良患者有效的复明手段。我国角膜供体严重匮乏,用自体角膜为载体可作为部分BostonI型人工角膜植入手术的可行方案。     

三维适形放疗联合吉非替尼治疗老年非小细胞肺癌的疗效

目的 观察三维适形放疗(3D-CRT)联合吉非替尼治疗老年非小细胞肺癌(NSCLC)的疗效及不良反应,评价患者的生活质量.方法 43例患者随机分为观察组(放疗加吉非替尼组)(22例)和对照组(单用吉非替尼组)(21例).两组均服用吉非替尼250 mg,1次／d,直到疾病进展、死亡或发生不可耐受的不良反应.观察组加适形放疗,每次2Gy,5次／w,至DT60 ～70 Gy.治疗3个月后,观察两组近期疗效、不良反应,并评价生活质量;随访2年评价客观疗效和生存率.结果 观察组有效率45.5％,高于对照组19.0％,两组比较有统计学差异(x2=4,P＜0.05).观察组Karnofsky计分提高+稳定者77.3％ (17/22),对照组为47.6％( 10/21),观察组生活质量改善优于对照组(x2=4.044,P＜0.05).与对照组相比,观察组不良反应发生率稍高于对照组,但差异无统计学意义.两组2年生存率比较无统计学差异(x2 =0.003 1,P＞0.05).结论 3D-CRT联合吉非替尼治疗老年NSCLC优于单用吉非替尼治疗,不良反应虽有所增加,但患者能耐受,值得临床上进一步推广应用.     

2014年北海舰队海军入伍新兵近视手术情况调查分析

目的 对2014年海军入伍新兵行近视手术情况进行调查,为部队新兵入伍的眼部标准提供参考.方法 横断面调查研究.选取青岛北海舰队新兵训练基地2014年海军新入伍所有男性新兵1 990例,在眼科入伍体检复检时,填写调查问卷,包括年龄、籍贯、学历、术前近视度数、手术方式、手术时间、手术医院以及术后不适感.根据术前屈光度数分为低度近视组和高度近视组,并根据手术后时间不同分为≤6个月组和＞6个月组,分别对两组术后不适感进行比较.组间样本率的比较采取卡方检验.结果 调查的1 990例新兵分别来自12个省、直辖市,其中曾行近视激光手术的新兵210例(420眼),占10.55％.手术方式中,准分子激光原位角膜磨镶术(LASIK) 154例(73.3％),飞秒激光制瓣的LASIK 24例(11.4％),准分子激光角膜上皮瓣下磨镶术(LASEK) 28例(13.3％),飞秒激光小切口角膜基质透镜取出术(SMILE)3例(1.5％),有晶状体眼后房型人工晶状体植入术(ICL)1例(0.5％).术后不适感包括阅读疲劳感33例(15.7％),夜视力下降15例(7.1％),眩光10例(4.7％),重影8例(3.8％).干眼的患者43例(20.5％).低度近视组和中高度近视组,术后存在阅读疲劳感、夜视力下降、眩光、重影患者比例比较差异均有统计学意义(x2=5.339、5.271、4.508、6.117,P＜0.05);术后时间≤6个月组和＞6个月组夜视力下降、阅读疲劳和干眼差异有统计学意义(x2=3.940、4.516、5.418,P＜0.05),而眩光、重影2组比较差异无统计学意义(x2=0.606、0.609,P＞0.05).结论 新兵近视激光手术术后不适感与术前近视度数和距离手术时间有关.新兵应征入伍的眼部体检标准应该对屈光手术前近视的度数,手术后时间以及视觉标准进行更细致的划分.     

应用自体阔筋膜前部覆盖治疗羟基磷灰石义眼座暴露

多孔羟基磷灰石(hydroxyaptite,HA)义眼座在眼球摘除术后的眼窝重建中,较之其它填充材料显示出较多的优点[1],已被临床广泛适用.但由于多孔粗糙的义眼座球体易对包裹组织造成摩擦或者义眼座直径过大,位置偏前,使筋膜囊、结膜囊缝合时张力过大,导致义眼座暴露,治疗起来颇为棘手.笔者所在科采用自体阔筋膜前部覆盖治疗义眼座暴露11例,现报告如下.     

N-甲基-D-天门冬氨酸受体亚型NR1、NR2A在大鼠视网膜缺血再灌注损伤模型中的表达

目的:研究N-甲基-D-天门冬氨酸受体(N-methyl-D-aspartate receptor,NMDAR)功能亚单位NMDAR1、NM-DAR2A在Wister大鼠视网膜缺血再灌注模型中的表达情况。方法:18只健康成年Wister大鼠分成6组,每组3只,都取其右眼行视神经周围血管结扎手术制备视网膜缺血再灌注模型,左眼作为对照组不行手术。60分钟后去除结扎缝线恢复血流,分别于再灌注后即刻、3、12、24、72、168小时处死大鼠,摘除眼球,做冰冻切片。用免疫组织化学方法观察NR1、NR2A在视网膜缺血再灌注后不同时刻的变化并进行图象分析及统计学处理。结果:(1)各实验组和对照组间及各实验组间NMDAR1的表达无统计学意义。(2)除即刻组外各实验组和对照组间及各实验组间NMDAR2A的表达均有统计学意义,从再灌注后3小时至168小时NMDR2A表达缓慢上升。结论:(1)NMDAR1与视网膜缺血再灌注损伤无关,不参与谷氨酸的兴奋性毒性作用。(2)NMDAR2A与视网膜缺血再灌注损伤有关,参与谷氨酸兴奋性毒性作用。     

J2对同种异体穿透性角膜移植模型大鼠CD4+和CD8+T细胞免疫功能的抑制

BACKGROUND: J2 takes functional domain (MHC CD4-D1/) of complex conjugate of CD4 molecule and MHC class II molecule as a target, and is a small molecule compound obtained by computer screening from a chemical data containing hundreds of thousands of organic compounds. In the previous study, J2 was used in mouse models of skin transplantation and keratoplasty by oral and intraperitoneal injection. Results verified that J2 could prolong the survival time of grafts, and suppress occurrence of rejection. To better play the role of a drug targeting and to reduce systemic toxicity, J2 will be further utilized in local treatment of keratoplasty rejection. OBJECTIVE: To investigate the inhibitory effect of new immunosuppressive agent J2 on CD4+ and CD8+ T cell immune functions in rat models receiving allogenic penetrating keratoplasty. METHODS: Allogeneic penetrating keratoplasty model was established using the adult female Wistar rats as donors and Sprague-Dawley rats as recipients. Group A: normal Sprague-Dawley rats were injected with 0.05 mL placebo subconjunctivally. Surgery rats were randomly divided into three groups. Group B: allograft rats were injected with 0.05 mL placebo subconjunctivally after autologous keratoplasty. Group C: allograft rats were injected with 0.05 mL placebo subconjunctivally. Group D: allograft rats were injected with 1% J2-nanosuspension 0.05 mL subconjunctivally. The distribution of T cell subsets in peripheral blood was detected using flow cytometry at 3 days, 1, 2 and 3 weeks after transplantation and compared among groups.  RESULTS AND CONCLUSION: There was no significant difference in total CD3+ T cells, CD4+ T cells, CD8+ T cells and CD4+/CD8+ in peripheral blood lymphocytes in group B at various time points. At 3 days and 1 week after surgery in group C, no significant difference in total CD3+ T cells, CD4+ T cells and CD8+ T cells was detected. At 1 and 2 weeks, the number of total CD3+ T cells, CD4+ T cells and CD8+ T cells increased, showing significant differences (P < 0.05). In group D, no significant hyperplasy was found in CD4+ T cells and CD8+ T cells at 1 and 2 weeks. The horizontal comparison of the same time point: the total CD3+ T lymphocytes of group D was significantly less than group C at 3 days, 1 and 2 weeks after operation (P < 0.05), whereas there was no significant difference at 3 weeks between the group D and group C. The number of CD4+ T lymphocytes in group D was less than in group C at 3 days and 1 week, but with no significant difference. The ratio of CD4+/CD8+ had no significant difference in group D compared with group C at 3 days, 1 and 3 weeks. J2 inhibits T lymphocyte proliferation and then inhibits T cell-mediated corneal allograft rejection.       

有晶状体眼人工晶状体植入术矫正高度近视在视觉质量上的优越性

有晶状体眼人工晶状体植入术（PIOL）是一种新的矫正高度近视的手术方法。视觉质量包括视力、对比敏感度（CS）、波前像差及角膜的非球面参数（Q值）等。传统的准分子激光角膜原位磨镶术（LASIK）由于切削改变角膜的非球面性导致术后视觉质量下降。可植入性接触镜（ICL）植入术具有矫治范围大和矫治高度近视及超高度近视安全、有效、手术并发症少的优点,在视觉质量的评价方面也优于LASIK。进一步提出对高度近视患者于术方案的选择,旨在寻求最适合患者的手术方式,进而获得最佳的视觉质量。     

三种准分子激光角膜切削术后中央角膜厚度变化的对比研究

目的比较三种准分子激光角膜切削术后中央角膜厚度(CCT)的差异并探讨不同手术方式角膜切削量的设定。方法使用Pentacam三维眼前段分析仪测量行SBK、LASIK、Epi-LASIK术的近视患者共136例266只眼术前术后的CCT,按屈光度分为低、中、高三组,分别计算和比较CCT及实际切削深度和设计切削深度的差值(Diff值)。结果Epi-LASIK患者低、中、高度组术前CCT分别为(495.70±24.94)、(501.57±31.34)和(525.18±16.53)μm,较SBK和LASIK组患者CCT明显偏薄(P0.01),SBK与LASIK患者术前术后的CCT无显著性差异。SBK、LASIK术后Diff值比较:低度组Diff值分别为(6.57±12.72)、(5.33±9.51)μm;中度组Diff值分别为(7.07±18.19)、(4.42±8.72)μm;高度组分别为Diff值(11.52±10.29)、(7.00±7.33)μm,各组比较差异均无显著性意义。三种手术方式的实际切削的角膜深度均大于设计量。结论CCT较薄的患者多选择Epi-LASIK。充分估计术中实际切削深度与设计切削深度存在的差异是提高手术安全性的保障。