兔血管内皮细胞对角膜后弹力层代谢的影响

目的:检测移植后生长于角膜内皮面的自体血管内皮细胞对角膜后弹力层代谢的影响.方法:家兔26只随机分成3组:实验组10只,将培养的自体血管内皮细胞移植到无后弹力层的角膜内皮面;实验对照组10只,移植无角膜内皮层的自体植片;空白对照组6只,移植带角膜内皮细胞的自体植片,术后观察3组角膜植片的水肿变化.术后15d,取下各组角膜植片做病理切片HE染色观察各组植片的角膜后弹力层变化及其上的细胞分布情况.结果:实验组角膜植片的内皮面长满培养的自体血管内皮细胞.病理切片显示,生长的细胞呈单层分布,内皮面未见明显的后弹力膜样物质形成;实验对照组角膜植片高度增厚,内皮面无细胞生长和后弹力膜样物质形成;空白对照组角膜植片内皮面可见明显的后弹力层,其上可见单层细胞分布.结论:血管内皮细胞具有一定的角膜内皮细胞样功能,但不能产生角膜后弹力层样物质.     

加速型角膜胶原交联术治疗真菌性角膜炎的临床研究

目的 评价角膜胶原交联术(CXL)治疗真菌性角膜炎的安全性和临床效果。 方法 对2017年1月-2019年12月期间济南市第二人民医院眼表疾病科确诊为“真菌性角膜炎”的患者92例(92眼),进行CXL治疗(观察组);同时回顾性分析2016年1月~2017年2月本院真菌性角膜炎单纯应用药物治疗的患者47例(47眼)的临床资料(对照组)。入组标准:病变深度<角膜厚度2/3;浅层的角膜溃疡,病变未累及的正常角膜厚度>400 μm;病变直径在3~6 mm范围、病变位置均偏离或少量影响瞳孔区;共聚焦显微镜可见真菌菌丝,真菌培养结果为镰刀菌。对两组治疗效果进行对比分析。 结果 观察组在术后2周开始,最佳矫正视力有显著改善,治疗效果优于对照组,差异有统计学意义(P<0.001);术后3个月最佳矫正视力较术前有显著提高,效果优于对照组,差异有统计学意义(P<0.001);观察组治疗2周后所有患眼的病变范围均保持稳定或缩小,术后3个月时,全部患眼病变区域均形成云翳,检查上皮愈合良好;观察组术后2周和术后1个月的真菌检出阳性率明显低于对照组,两组差异有统计学意义(P<0.001);随访期间,观察组所有患者均无真菌性疾病复发,且无并发症出现。 结论 针对范围较小、偏中心的真菌性角膜炎,CXL可以显著缩短病程,提高视力,是一种安全有效的治疗方法。     

Adipose Tissue Aging and Metabolic Disorder,and the Impact of Nutritional Interventions

Adipose tissue is the largest and most active endocrine organ, involved in regulating energy balance, glucose and lipid homeostasis and immune function. Adipose tissue aging processes are associated with brown adipose tissue whitening, white adipose tissue redistribution and ectopic deposition, resulting in an increase in age-related inflammatory factors, which then trigger a variety of metabolic syndromes, including diabetes and hyperlipidemia. Metabolic syndrome, in turn, is associated with increased inflammatory factors, all-cause mortality and cognitive impairment. There is a growing interest in the role of nutritional interventions in adipose tissue aging. Nowadays, research has confirmed that nutritional interventions, involving caloric restriction and the use of vitamins, resveratrol and other active substances, are effective in managing adipose tissue aging’s adverse effects, such as obesity. In this review we summarized age-related physiological characteristics of adipose tissue, and focused on what nutritional interventions can do in improving the retrogradation and how they do this.     

阻塞性睡眠呼吸暂停综合征患者上呼吸道的CT研究

目的 :探讨阻塞性睡眠呼吸暂停综合征 (OSAS)患者和正常人的上呼吸道CT资料的差异。方法 :对经多导睡眠监测 (PSG)确诊的OSAS患者和年龄性别相近的正常成年人各 5 3例 ,采用螺旋CT对上呼吸道进行连续扫描 ,测量并比较两组间有关数据。结果 :OSAS组软腭后区、悬雍垂区和舌后区的横截面积均明显小于对照组 ;左右径在所测量的 4个平面中均明显短于对照组 ;而前后径的比较除悬雍垂区以外 ,两组间差异均不明显 ;前后径 /左右径比值在会厌后区差异不显著 ,其余 3个区域差异明显 ;咽后壁的软组织厚度比较软腭后区和悬雍垂区差异明显 ,咽侧壁的软组织厚度比较 ,4个测量平面差异均显著 ,软腭后区咽侧脂肪面积比较差异不显著。结论 :上呼吸道的解剖性狭窄是OSAS的主要发病原因之一 ,造成上呼吸道解剖性狭窄的主要原因是咽侧壁软组织的明显增厚并导致气道左右径的缩短     

Cornuside Is a Potential Agent against Alzheimer’s Disease via Orchestration of Reactive Astrocytes

Cornuside is an iridoid glycoside from Cornus officinalis, with the activities of anti-inflammatory, antioxidant, anti-mitochondrial dysfunction, and neuroprotection. In the present research, a triple-transgenic mice model of AD (3 × Tg-AD) was used to explore the beneficial actions and potential mechanism of cornuside on the memory deficits. We found that cornuside prominently alleviated neuronal injuries, reduced amyloid plaque pathology, inhibited Tau phosphorylation, and repaired synaptic damage. Additionally, cornuside lowered the release of interleukin-1β (IL-1β), interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α), and nitric oxide (NO), lowered the level of malondialdehyde (MDA), and increased the activity of superoxide dismutase (SOD) and the level of glutathione peroxidase (GSH-Px). Cornuside also significantly reduced the activation of astrocytes and modulated A1/A2 phenotypes by the AKT/Nrf2/NF-κB signaling pathway. We further confirmed that LY294002 and Nrf2 silencing could block the cornuside-mediated phenotypic switch of C6 cells induced by microglia conditioned medium (MCM) in response to lipopolysaccharide (LPS), which indicated that the effects of cornuside in astrocyte activation are dependent on AKT/Nrf2/NF-κB signaling. In conclusion, cornuside may regulate the phenotypic conversion of astrocytes, inhibit neuroinflammation and oxidative stress, improve synaptic plasticity, and alleviate cognitive impairment in mice through the AKT/Nrf2/NF-κB axis. Our present work provides an experimental foundation for further research and development of cornuside as a candidate drug for AD management.     

甲巯咪唑与抗中性粒细胞胞浆抗体阳性血管炎的关系

目的 研究抗甲状腺药物甲巯咪唑(MMI)与抗中性粒细胞胞浆抗体(ANCA)阳性血管炎的关系.方法 对33例Graves病患儿在服药前及服药后检测血ANCA.同时对我院近年来诊治的2例毒性弥漫性甲状腺肿(Graves病)患儿在服用MMI期间出现ANCA阳性血管炎进行临床病理分析.结果 2例患儿在服用MMI第5～6年出现抗中性粒细胞胞浆抗体阳性血管炎,临床出现血尿、肾功能减退,肾活检示肾血管炎改变,急性肾血管坏死伴新月体形成.经免疫抑制剂等治疗临床缓解;33例Graves病患儿服药前血ANCA均为阴性.有3例患儿分别在服用MMI第2、3个月及2年时出现ANCA阳性,阳性率9%(3/33).临床出现镜下血尿,服药后ANCA阳性率高于服药前(x2=5.3,P<0.05).3例患儿经对症治疗后镜下血尿消失,血ANCA复查转阴性.结论 MMI与ANCA阳性血管炎可能有关,可产生从轻到重的肾脏受累临床表现,采用不同的治疗方法可使症状消失.     

儿童Alport综合征30例肾脏和皮肤Ⅳ胶原分布特点

目的通过分析30例Alport综合征（AS）患儿肾脏和皮肤Ⅳ胶原分布特点,探讨Ⅳ胶原分布与临床表型的关系。方法对30例Alport综合征患儿资料进行总结,并分析。肾组织穿刺和皮肤活检中肾脏和皮肤Ⅳ胶原分布特点,总结不同的Ⅳ型胶原仪链分布方式与临床表型的相关关系：结果30例患儿中29例表现为肾脏和（或）皮肤Ⅳ胶原Ⅸ链分布异常,1例正常。其中24例（占80．0％）为X连锁显性遗传性AS（XDAS）,男20例,女4例;5例（占16．7％）为常染色体隐性遗传性AS（ARAS）。XDAS组患儿1例临床表现为孤立性血尿型（4．2％）,6例为血尿合并蛋白尿型（25．0％）,16例为肾痫综合征型（66．7％）,1例为肾功能不全型（4．1％）;平均尿蛋白定量男1．74g／24h,女0,83g／24h;3例发现高频听力减退均为男性,男性患儿病情明显重于女性。ARAS组患儿5例均表现为血尿合并蛋白尿型;平均尿蛋白定量0．62g／24h;未发现眼耳损害。结论XDAS患儿病情重,病程进展快,不同性别在病情严重程度上行住明显的差异;ARAS患儿病情相对较轻。Alport综合征的Ⅳ型胶原α链分布与临床表型密切相关。肾脏和皮肤Ⅳ胶原免疫荧光检测是目前诊断Alport综合征的有效手段,对判断疾病严重程度和远期预后鄯奄重要意义。     

Crohn’s disease,autoimmune thyroiditis,and beta-thalassemia trait in an adolescent: an unusual combination of diseases

An adolescent with complaints of fatigue, tachycardia, abdominal discomfort, and blood-stained diarrhea is presented. Clinical and laboratory evaluation revealed a microcytemic anemia with iron deficiency, beta thalassemia, and thyrotoxicosis with thyroid antibodies. Crohn’s disease was confirmed on endoscopy. A rapid normalization of clinical and laboratory parameters was observed following the initiation of therapy and further exacerbation of her illness was prevented. Although the simultaneous occurrence of Crohn’s disease, autoimmune thyroiditis, and a beta-thalassemia trait is likely to be coincidental, the combination of an autoimmune thyroid disease and Crohn’s disease is rare in pediatrics. Several issues of importance in the treatment of these conditions are discussed. Rectal blood loss associated with Crohn’s disease may lead to severe iron deficiency, especially in patients with preexistent beta-thalassemia trait, and those with thyroiditis are prone to developing hypothyroidism following treatment, requiring that they be monitored closely.