分期实施异体角膜缘干细胞移植与穿透性角膜移植术治疗严重化学伤(英文)

有1位于1996年实施右眼穿透性角膜移植术失败的双眼严重眼表化学伤的患者, 62岁,右眼视力手动,左眼视力光感。于2006-09-16/2007-02-07分别对右眼实施了异体角膜缘干细胞移植术和穿透性角膜移植术,经过术后5m的药物治疗观察,最终获得了右眼最佳矫正视力为6/30,角膜移植片透明,眼表得以重建,并未发现明显排斥迹象的良好效果。     

Exploring the mechanistic insights of Cas scaffolding protein family member 4 with protein tyrosine kinase 2 in Alzheimer’s disease by evaluating protein interactions through molecular docking and dynamic simulations

Cas scaffolding protein family member 4 and protein tyrosine kinase 2 are signaling proteins, which are involved in neuritic plaques burden, neurofibrillary tangles, and disruption of synaptic connections in Alzheimer’s disease. In the current study, a computational approach was employed to explore the active binding sites of Cas scaffolding protein family member 4 and protein tyrosine kinase 2 proteins and their significant role in the activation of downstream signaling pathways. Sequential and structural analyses were performed on Cas scaffolding protein family member 4 and protein tyrosine kinase 2 to identify their core active binding sites. Molecular docking servers were used to predict the common interacting residues in both Cas scaffolding protein family member 4 and protein tyrosine kinase 2 and their involvement in Alzheimer’s disease-mediated pathways. Furthermore, the results from molecular dynamic simulation experiment show the stability of targeted proteins. In addition, the generated root mean square deviations and fluctuations, solvent-accessible surface area, and gyration graphs also depict their backbone stability and compactness, respectively. A better understanding of CAS and their interconnected protein signaling cascade may help provide a treatment for Alzheimer’s disease. Further, Cas scaffolding protein family member 4 could be used as a novel target for the treatment of Alzheimer’s disease by inhibiting the protein tyrosine kinase 2 pathway.     

两性霉素B角膜基质内注射成功治疗真菌性角膜炎1例

目的:报告1例使用5mg/L两性霉素成功治疗难治性真菌性角膜炎的病例。方法:病例报告。结果:女性患者1例,48岁,以右眼红1wk,伴视力下降和角膜混浊2d入院。否认有外伤或异物史。检查发现:右眼视力:6/12,针孔视力:6/18。注射结膜前使眼分泌物保持最少。角膜旁中央区有一全层基质脓肿-形态不规则且伴有卫星病灶及羽状边缘,不伴有上皮缺损,有前房积脓液平。左眼正常。诊断为真菌性角膜炎。尽管在此前患者经历了3wk的局部两性霉素B点眼(1次/2h),那他霉素眼液点眼(1次/4h),但并无病情恢复的迹象。相反12点出现了一个新的更大的基质脓肿病灶。我们应用5mg/L两性霉素B角膜基质注射联合穿透性角膜移植术治疗后溃疡面积明显减少,前房积脓完全消失,没有毒性反应发生。患者干预后2mo视力恢复了正常视力(6/6)。结论:使用两性霉素B5mg/L基质内注射,使用过程安全有效,是一种治疗难治性真菌性角膜炎的理想方法。     

Modified Bahasa Malaysia version of VF-14 questionnaire: assessing the impact of glaucoma in rural area of Malaysia

Purpose: To evaluate the functional impairment of glaucoma patients, using a modified Bahasa Malaysia version of VF‐14 questionnaire, and to correlate the score with the severity of the disease. Methods: One‐to‐one interview by trained interviewers was conducted on glaucoma patients seen in the eye clinic of Hospital Universiti Sains Malaysia, using a modified validated Bahasa Malaysia version of VF‐14 questionnaire. The severity of glaucoma was determined based on the better‐eye Advanced Glaucoma Intervention Study Scale (AGIS) score of visual field analysis on the latest most reliable visual field. The literacy rate, living situation, better‐eye visual acuity and lens status were also documented. Results: A total of 110 glaucoma patients were recruited (54.5% primary open‐angle glaucoma, 21.8% primary angle‐closure glaucoma, 19.2% normotensive glaucoma and 4.5% pseudoexfoliative glaucoma) and majority with bilateral involvement. Based on the better‐eye AGIS score, 41.5% were in advanced stage, 29.1% moderate and 29.1% mild. There was a significant association between VF‐14 scoring with the better‐eye AGIS score (r =?0. 579, P < 0.001), age (r = ?0.313, P = 0.000) and better‐eye visual acuity (r = ?0.752, P = 0.000). Based on the multivariate analysis, there was a significant association of the questionnaire score and better‐eye AGIS score (P < 0.001). Conclusion: The Bahasa Malaysia version of modified VF‐14 questionnaire is a useful tool in quantifying quality of life among glaucoma patients in rural area with high illiteracy rate and provides moderate correlation with severity of the disease. Customization of quality of life questionnaire according to custom and culture of the community will provide better insight to the functional impairment of glaucoma patients.     

纤维蛋白胶封闭早期滤过泡漏1例

患者,男,63岁,以“左眼突发视力下降,眼部不适,眼红,流泪”主诉就诊。1wk前因继发性青光眼行青光眼阀植入术。同一眼1a前曾行扩大的小梁切除术,手术失效。眼科检查结果：最佳矫正视力为6／18,有滤过泡漏,前房浅,眼压6mmHg。应用纤维蛋白胶成功封闭滤过泡漏,前房加深,眼压升至13mmHg。此病例说明纤维蛋白胶是治疗早期滤过泡漏的有效方法。     

Dengue related maculopathy and foveolitis

A 24 year-old Malay lady presented with high grade fever, myalgia, generalized rashes, severe headache and was positive for dengue serology test. Her lowest platelet count was 45 × 10⁹ cells/L. She complained of sudden onset of painlessness, profound loss of vision bilaterally 7 days after the onset of fever. On examination, her right eye best corrected vision was 6/30 and left eye was 6/120. Her anterior segment examination was unremarkable. Funduscopy revealed there were multiple retinal haemorrhages found at posterior pole of both fundi and elevation at fovea area with subretinal fluid. Systemic examination revealed normal findings except for residual petechial rashes. She was managed conservatively. Her vision improved tremendously after 2 months. The retinal hemorrhages and foveal elevation showed sign of resolving. Ocular manifestations following dengue fever is rare. However, bilateral visual loss can occur if both fovea are involved.     

外伤性视神经病变24例回顾研究

目的:探讨的外伤性视神经病变的临床表现,评估在眼科第三病区住院的经过三组不同处理(保守估计,单独静脉注射皮质类固醇,静脉注射和口服皮质类固醇联合治疗)的外伤性视神经病变患者的治疗效果。方法:对2007-01/2009-12在马来西亚医科大学眼科连续住院的24例27眼外伤性视神经患者进行了回顾性研究。结果:本次研究对象为24例27眼男性外伤性视神经患者(平均年龄为33岁)。车祸是导致发病的主要原因(83%)。大部分患者的视力低下(手动/眼前～无光感约占82%),其中有22眼并发眶周血肿,20眼并发有结膜下出血。并发多于一骨(颅骨或眶骨)骨折有19例(79%),5例(21%)没有出现骨折。CT扫描或核磁共振检查显示患者均没有视神经压迫的证据。第一组: 11例(46%)患者进行静脉注射联合口服类固醇的治疗;第二组:7例患者(29%)进行保守治疗;第三组:6例(25%)患者给予静脉注射皮质类固醇治疗。92%(11/12眼)给予静脉注射和口服类固醇治疗的患者和78%保守治疗患者视力能提高1行。单独静脉注射皮质类固醇治疗的患者4例呈现无光感,1例有轻度视力改善,而其他患者视力保持不变。保守治疗患者和单独静脉注射皮质类固醇患者视力改善不显著,且两组间相比在统计学上无显著性差异(P=0.368)。静脉注射联合口服类固醇治疗的患者有明显的视觉改善(P<0.05)。没有患者接受视神经减压手术。在本研究中,随访时间为6mo～3a。结论:大部分外伤性视神经病变患者都存在有眶周血肿,结膜下出血,眶壁骨折的症状。对比保守治疗,经过静脉注射和口服皮质类固醇联合治疗的患者有更好的治疗效果。     

纤维蛋白胶封闭早期滤过泡漏1例(英文)

患者,男,63岁,以"左眼突发视力下降,眼部不适,眼红,流泪"主诉就诊。1wk前因继发性青光眼行青光眼阀植入术。同一眼1a前曾行扩大的小梁切除术,手术失效。眼科检查结果:最佳矫正视力为6/18,有滤过泡漏,前房浅,眼压6mmHg。应用纤维蛋白胶成功封闭滤过泡漏,前房加深,眼压升至13mmHg。此病例说明纤维蛋白胶是治疗早期滤过泡漏的有效方法。     

Computational investigation of mechanistic insights of Aβ42 interactions against extracellular domain of nAChRα7 in Alzheimer’s disease

Aim: Amyloid beta (Aβ) 1-42, which is a basic constituent of amyloid plaques, binds with extracellular transmembrane receptor nicotine acetylcholine receptor α7 (nAChRα7) in Alzheimer’s disease.

Materials and Methods: In the current study, a computational approach was employed to explore the active binding sites of nAChRα7 through Aβ 1–42 interactions and their involvement in the activation of downstream signalling pathways. Sequential and structural analyses were performed on the extracellular part of nAChRα7 to identify its core active binding site.

Results: Results showed that a conserved residual pattern and well superimposed structures were observed in all nAChRs proteins. Molecular docking servers were used to predict the common interactive residues in nAChRα7 and Aβ1–42 proteins. The docking profile results showed some common interactive residues such as Glu22, Ala42 and Trp171 may consider as the active key player in the activation of downstream signalling pathways. Moreover, the signal communication and receiving efficacy of best-docked complexes was checked through DynOmic online server. Furthermore, the results from molecular dynamic simulation experiment showed the stability of nAChRα7. The generated root mean square deviations and fluctuations (RMSD/F), solvent accessible surface area (SASA) and radius of gyration (Rg) graphs of nAChRα7 also showed its backbone stability and compactness, respectively.

Conclusion: Taken together, our predicted results intimated the structural insight on the molecular interactions of beta amyloid protein involved in the activation of nAChRα7 receptor. In future, a better understanding of nAChRα7 and their interconnected proteins signalling cascade may be consider as target to cure Alzheimer’s disease.