维生素D及其类似物治疗视网膜母细胞瘤的研究进展

视网膜母细胞瘤的维生素D疗法是一种非诱变的化学疗法。本文综述了20a来,国内外许多学者对维生素D及其类似物治疗视网膜母细胞瘤进行的广泛研究,其抗癌作用已经得到肯定。现分别从维生素D及其类似物治疗视网膜母细胞瘤的分子机制、毒副作用及其应用前景方面进行综述。     

对转基因鼠视网膜母细胞瘤的外源放射“挽救性”治疗

目的：在遗传性视网膜母细胞瘤模型鼠中，检测低剂量外源放射治疗(EBRT)对于应用结膜下碳铂化疗失败后的有效性。方法：研究的84只眼来自于8周大的simian病毒40的T抗原阳性鼠，它们接受了6个序列的结膜下碳铂注射治疗(100ug／25uL)。在12周大时，其中64只眼接受的总浓度为480(4．8Gy)rad，1200(12．0Gy)rad，1560(15．6Gy)rad或3000(30．0Gy)rad。20只眼在接受了卡柏结膜下注射治疗后未接受任何其他治疗。10只眼接受的总剂量为3000rad的EBRD。8只眼仅接受了同位素NaCl溶液的结膜下注射治疗。10只眼作为未接受治疗的对照。     

视网膜母细胞瘤动物模型的研究进展

视网膜母细胞瘤动物模型的建立对研究肿瘤的发生机理,正确评价各种治疗方案等具有重要的意义.本文对视网膜母细胞瘤动物模型从裸鼠移植瘤模型到转基因小鼠模型的发展,其原理、实验方法和特点,以及最新的研究动态进行综述.     

活性维生素D治疗非增殖型糖尿病视网膜病变的疗效

目的:探讨活性维生素D(骨化三醇)治疗非增殖型糖尿病视网膜病变的临床疗效。方法:选取本院眼科门诊及内分泌科病房诊断明确的2型糖尿病视网膜病变患者96例,患者按随机数字表法随机均分为对照组(C组)和观察组(T组)各48例,C组给予二甲双胍降糖治疗,T组患者在对照组的基础上给予骨化三醇0.25μg/d治疗。另选取本院体检中心健康体检者20例作为正常组(N组),观察各组患者治疗前后血清钙、磷、25-(OH)D3、1,25-(OH)2D3及甲状旁腺激素(PTH)水平,并观察两组患者治疗后眼底病变减轻的有效率。结果:与N组相比,C组、T组患者治疗前均存在血清25-(OH)D3和1,25-(OH)2D3水平低下,甲状旁腺素上升;给予骨化三醇治疗后,T组患者维生素D及甲状旁腺素水平有改善,同时视力及眼底出血渗出均改善,有效率明显高于C组,两组比较差异均有统计学意义(P<0.05)。以上三组患者治疗前后血清钙、磷水平差异无统计学意义。结论:DR患者存在血清维生素D代谢紊乱,给予维生素D治疗可以改善其代谢紊乱,同时可以明显改善患者视力及眼底病变。     

视网膜母细胞瘤化疗减容加局部治疗瘤体后的临床消退类型分析

目的：探讨视网膜母细胞瘤化疗减容加局部治疗后瘤体的消退类型及预后。方法回顾性病例研究。63例（93眼）视网膜母细胞瘤患者在经过化疗减容加局部治疗后的消退类型进行回顾性分析。结果138个视网膜母细胞瘤体消退类型分为五型：0型（n=3）,1型（n=19）,2型（n=6）,3型（n=35）,4型（n=75）。肿瘤初始厚度小于或等于3mm的消退类型多为4型（84.21%）,初始厚度在3~8mm的肿瘤多为3型（34.43%）和4型（40.98%）,初始厚度大于8mm的肿瘤多为1型（35.00%）和3型（50.00%）。在黄斑区的瘤体中常见3型（45.10％）和4型（33.33％）消退类型,在黄斑区-赤道部和赤道部-锯齿缘区的瘤体中常见4型消退类型（54.35％,80.48％）。138个瘤体中其中有14个（10.14%）瘤体复发,其中有2个为0型瘤体,3个为1型瘤体,1个为2型瘤体,8个为3型瘤体。结论化疗减容加局部治疗后4型及3型消退类型最常见。多数小的瘤体转为萎缩瘢痕,中间大小的瘤体多转为萎缩瘢痕或部分钙化残留,大的瘤体多转为完全或部分钙化残留。3型消退类型的瘤体可能易复发。     

Quantitative Analysis of Tumor Size in a Murine Model of Retinoblastoma

Murine models can provide valuable insight into mechanisms of tumorigenesis. Tumor size is often used to assess the impact of genetic insult or therapeutic treatment, usually using in vivo imaging of advanced tumors. We now describe a highly sensitive method to quantify tumor volume in a mouse model of retinoblastoma, from the earliest stages of tumor initiation to large, advanced tumors. This methodology combines immunohistochemistry, digital slide scanning and computer image analysis, and can be applied to quantitatively assess and characterize early tumor development in other models.     

Development of New Solitary Retinoblastoma Tumors during and after Chemotherapy

PurposeTo review the occurrence of new solitary tumors during and after intravenous chemotherapy against retinoblastoma.MethodsFrom 115 eyes of 78 patients with a diagnosis of intraocular retinoblastoma who underwent intravenous chemotherapy and focal treatment without prior treatment, patient demographics, age at diagnosis, laterality, classification (Reese-Ellsworth and International Classification of Retinoblastoma), and treatment options were recorded. In addition, the occurrence of small tumors during and after chemotherapy was documented with a detailed review of medical records and fundus photographs.ResultsOf a total of 115 eyes of 78 consecutive patients, new solitary tumors were observed in 50 eyes (50 / 115, 43%) of 40 patients (40 / 78, 51%). Multinominal logistic regression analyses showed that age at diagnosis (before 1 year) and vitreal seeding at diagnosis were linked to the development of isolated and miliary tumors, respectively. Kaplan-Meier analyses demonstrated that all small tumors developed with 20 months from the start of chemotherapy. Twenty-eight eyes (28 / 34, 82%) were salvaged with additional focal treatment in 34 eyes with isolated tumors.ConclusionsSmall tumors were observed during and after chemotherapy against retinoblastoma in patients who underwent intravenous chemotherapy and focal treatment. It is necessary to promptly identify and address small tumors for the preservation of eyeball and vision.     

EDWARD COTLIER AND ROBERT WEINREB, EDITORS Retinoblastoma in Transgenic Mice: Models of Hereditary Retinoblastoma

Retinoblastoma, the most common intraocular malignancy in childhood, has served as a paradigm for the study of genetic mechanisms of oncogenesis. The retinoblastoma susceptibility gene RB1 was the first tumor suppressor gene to be cloned, and genetic and molecular biologic studies of this tumor have greatly expanded the understanding of the mechanics of tumorigenesis. Human retinoblastoma has essentially no naturally occurring animal counterpart. The development of transgenic murine models of retinoblastoma have created an experimental tool for manipulation of a tumor gene system in vivo. These models have also enabled studies of new therapeutic modalities. This review outlines the development of the transgenic murine models of retinoblastoma, together with the genetic mechanisms of retinoblastoma origin. Current therapeutic innovations developed by means of the transgenic models are described.     

Enhancement of Vitamin D Metabolites in the Eye Following Vitamin D3 Supplementation and UV-B Irradiation

Purpose: This study was designed to measure vitamin D metabolites in the aqueous and vitreous humor and in tear fluid, and to determine if dietary vitamin D3 supplementation affects these levels. We also determined if the corneal epithelium can synthesize vitamin D following UV-B exposure. Methods: Rabbits were fed a control or vitamin D3 supplemented diet. Pilocarpine-stimulated tear fluid was collected and aqueous and vitreous humor were drawn from enucleated eyes. Plasma vitamin D was also measured. To test for epithelial vitamin D synthesis, a human corneal limbal epithelial cell line was irradiated with two doses of UV-B (10 and 20 mJ/cm(2)/day for 3 days) and vitamin D was measured in control or 7-dehydrocholesterol treated culture medium. Measurements were made using mass spectroscopy. Results: 25(OH)-vitamin D3 and 24,25(OH)(2)-vitamin D3 increased significantly following D3 supplementation in all samples except vitreous humor. Tear fluid and aqueous humor had small but detectable 1,25(OH)(2)-vitamin D3 levels. Vitamin D2 metabolites were observed in all samples. Vitamin D3 levels were below the detection limit for all samples. Minimal vitamin D3 metabolites were observed in control and UV-B-irradiated epithelial culture medium except following 7-dehydrocholesterol treatment, which resulted in a UV-B-dose dependent increase in vitamin D3, 25(OH)-vitamin D3 and 24,25(OH)(2)-vitamin D3. Conclusions: There are measurable concentrations of vitamin D metabolites in tear fluid and aqueous and vitreous humor, and oral vitamin D supplementation affects vitamin D metabolite concentrations in the anterior segment of the eye. In addition, the UV exposure results lead us to conclude that corneal epithelial cells are likely capable of synthesizing vitamin D3 metabolites in the presence of 7-dehydrocholesterol following UV-B exposure.     

曲安奈德囊内注射加压包扎治疗耳廓假性囊肿

目的研究糖皮质激素类药囊内使用治疗耳廓假性囊肿的效果,并观察加压包扎对疗程及愈合后效果的影响.方法随机选取60名门诊就诊的耳廓假性囊肿患者,在囊液抽尽后囊内注射曲安奈德注射液治疗.60名患者随机分成两组,每组30名,甲组注药后加压包扎,乙组注药后不作包扎,观察两组疗程长短及恢复后耳廓软骨增厚情况的差异.结果 60名患者经曲安奈德囊内注射治疗后均囊肿消失、耳廓无畸形,随访6个月～6年囊肿无复发,有效率为100%.乙组平均疗程较甲组长(P＜0.01),大部分患者存在不同程度的软骨增厚.结论囊内注射曲安奈德可有效地治疗耳廓假性囊肿,同时加压包扎可以缩短疗程、防止软骨增厚.具有治疗简单、安全、痛苦小、费用低等优点.