Combined use of Ad-hENDO-VEGI151 and Dexamethasone for prevention and treatment of keratoplasty rejection.an experimental study

Objective:To evaluate the probability and efficacy of endostatin-vascular endothelial growth inhibitor (VEGI) recombinant adenoviruses combined with dexamethasone on suppressing heterolamellar corneal transplantation rejection. Methods: Heterolamellar corneal transplantation models were established in 64 New Zealand rabbits, which were randomized into 4 groups of 16 rabbits each. After the transplantation, all the 64 right eyes were injected subconjunctively with 0. 2 ml saline (saline group), 0. 1 ml AdCA13-hENDO-VEGI151 plus 0. 1 ml saline (AdCA13-hENDO-VEGI151 group), 0. 1 ml Dexamethasone (DXM) plus 0. 1 ml saline (DXM group), 0. 1 ml AdCA13-hENDO-VEGI151 plus 0. 1 ml DXM (Ad-CA13-hENDO-VEGI151 combined with DXM group) with one time each 3 days for 10 times. Graft survival and ocular surface were observed for 6 weeks. The fusion protein expression was detected by immunohistochemistry 6 weeks after transplantation. Results: Both the CNV index, rejection index and the xenograft rejection rate in the AdCA13-hENDO-VEGI151 combined with DXM group were statistically lower than those in other groups. AdCA13-hENDO-VEGI151 combined with DXM group: 1. 375 0±0. 500 0, 2. 750 0 ±1. 843 9 and 6. 25% respectively 6 week after keratoplasty; Saline group: 3. 437 5±0. 512 3, 8. 812 5± 1.1087, 100.00%; AdCAl3-hENDO-VEGI151 group: 2. 312 5±0. 478 7, 5. 625 0±0. 957 4, 62.50%; DXM group: 3. 000 0±0. 816 5, 5. 562 5±1. 315 0, 56.25% (P<0. 01). Immunohistochemical staining showed the fusion protein expressed mainly in corneal epithelium. Conclusion: The fusion protein expressed by the recombinant adenovirus has significant effect on inhibiting neovascularization after heterolamellar corneal transplantation. The topical application of AdCA13-hENDO-VEGI151 combined with DXM suppressed effectively the postoperative xenograft rejection rate of heterolamellar corneal transplantation.     

糖尿病视网膜病变患者血清β2-糖蛋白Ⅰ的表达

目的探讨血清β2-糖蛋白Ⅰ(beta2-glycoproteinⅠ,β2-GPⅠ)在不同时期糖尿病视网膜病变(diabetic retinopathy,DR)患者中的变化,了解血清β2-GPⅠ与DR的关系。方法收集60例2型糖尿病患者血清标本,将其分为3组:20例无明显DR(no-DR,NDR)患者为NDR组;20例非增生性DR(non-proliferative DR,NPDR)患者为NPDR组;20例增生性DR(proliferative DR,PDR)患者为PDR组。同时收集20例健康人血清为正常对照(normal control,NC)组。应用Westernblot方法,对各组随机抽取的4份血清样本中β2-GPⅠ水平进行分析。结果β2-GPⅠ水平在NPDR组、PDR组大量表达,在NDR组中量表达,在NC组少量表达。NC组、NDR组、NPDR组和PDR组各条带面积平均光密度值,分别为(440564.9±66597.4)mm-2、(655561.6±85640.8)mm-2、(859969.7±85461.0)mm-2、(954887.4±125764.4)mm-2。与NC组比较,β2-GPⅠ水平在NDR组、NPDR组、PDR组显著升高,差异均有统计学意义(均为P<0.01);与NDR组比较,β2-GPⅠ水平在NPDR组、PDR组显著升高,差异均有统计学意义(均为P<0.01);与NPDR组比较,PDR组无明显升高,差异无统计学意义(P>0.05)。结论在DR发生过程中,血清β2-GPⅠ水平上调,β2-GPⅠ可能具有潜在的早期诊断DR的价值。     

小针刀治疗跟骨骨刺60例

足跟骨骨刺是骨科临床上的常见病,多发病。笔者用小针刀治疗本病,疗效满意,报道如下。     

TGF-β与原发性开角型青光眼

TGF-β作为一种多功能细胞因子,具有多种生物学效应.它能调控小梁细胞外基质的合成与分泌及小梁细胞的收缩而影响房水流出阻力,促进青光眼滤过术后结膜瘢痕形成.TGF-β可能在原发性开角型青光眼(POAG)的发病机制中起重要作用,TGF-β抑制剂可能成为青光眼滤过术后抗结膜瘢痕化的辅助药物.     

严重眼球开放性外伤Ⅱ期玻璃体视网膜手术的效果及意义

目的探讨玻璃体视网膜手术治疗严重眼球开放性外伤的效果及意义。方法对40例（40眼）严重眼球开放性外伤I期清创缝合后Ⅱ期行玻璃体视网膜手术的效果作回顾性分析,术后随访5个月至3年,平均随访（13．18±8．45）个月。结果本组术后40眼中视力较术前提高者29眼,视力不变7眼,视力下降4眼。功能治愈27眼（67．50％）;解剖治愈9眼（22．50％）;未愈4眼（10．00％）。主要远期并发症有增生性玻璃体视网膜病变和视网膜脱离。结论玻璃体视网膜手术是治疗严重眼球开放性外伤的有效途径,能够最大限度地保留患者的眼球,并保持眼球的外形,部分能挽救视功能。     

玻璃体切割联合内界膜剥离术治疗特发性黄斑裂孔

目的评价玻璃体切割联合内界膜剥离术治疗特发性黄斑裂孔的临床疗效。方法采用玻璃体切割联合内界膜剥离术治疗特发性黄斑裂孔17例17眼,对患者术前术后视功能、术后黄斑裂孔闭合及手术主要并发症等进行检查和随访。结果本组17眼均成功剥离内界膜。随访5～24个月,其中13眼黄斑裂孔完全闭合,4眼裂孔直径缩小,裂孔封闭成功率为76.47%;17眼中14眼视力提高,视力提高率为82.35%;视物变形等症状也有明显改善。并发症主要有术中毛细血管性出血、术后一过性高眼压及晶状体后囊下混浊。结论玻璃体切割联合内界膜剥离术可有效封闭特发性黄斑裂孔,提高视功能。     

RVO患者房水MCP-1、IL-8表达与黄斑水肿相关分析

目的 研究视网膜静脉阻塞(Retinal vein occlusion, RVO)患者房水中白介素-8(Interleukin-8、IL-8)、单核细胞趋化因子-1(MCP-1)的水平与RVO继发黄斑水肿之间的关系。方法 选取2021年7月至2023年2月在我院眼科住院行抗血管内皮生长因子(Vascular endothelial growth factor, VEGF)治疗的视网膜静脉阻塞型黄斑水肿(Macular edema due to retinal vein occlusionRVO-ME)为研究组(n=55),对照组为同时段于我院行白内障手术的患者(n=15)。房水采集后，用ELISA检测房水中IL-8、MCP-1的浓度，收集被研究者的中央视网膜厚度(central retinal thickness, CRT)、最佳矫正视力(best corrected visual acuity,BCVA)、视网膜下积液高度(subfoveal serous retinal thickness, SRT)。按照不同的分组标准进行数据分析。结果 实验组的高血压患病率、IL-8、MCP-1...