简介:目的:研究角膜胶原交联方法联合那他霉素应用时的体内外抗真菌效果,为临床真菌性角膜炎的治疗提供治疗方法及实验基础。方法:采用黄曲霉菌、茄病镰刀菌、白色念珠菌三种常见致病真菌,实验组分为交联联合那他霉素组、那他霉素联合核黄素组、那他霉素联合紫外照射组、交联组,并用那他霉素组作为对照。将药物涂到有1.5麦氏浊度的真菌孢子悬液的沙堡弱琼脂培养皿的中心,10min后使用胶原交联仪照射10min,之后28℃培养36h,测量抑菌圈并进行统计学分析。制备兔眼茄病镰刀菌感染模型,按随机数字表法将模型兔随机分为模型对照组、交联治疗组、那他霉素治疗组、交联联合那他霉素治疗组,每组5只;另取5只正常兔按照角膜胶原交联疗法进行照射,5只正常对照。通过前节照相、角膜刮片、共焦显微镜等观察各组治疗结果,并在治疗结束后采用电镜观察角膜超微结构改变情况。结果:体外单独应用角膜胶原交联术,对三种真菌均无效;当交联与那他霉素联合应用时,抗真菌效果均优于对照组,且差异具有统计学意义(P<0.05);那他霉素与核黄素、那他霉素与紫外线分别联合应用时,抗菌效果与对照组比较,差异均无统计学意义(P>0.05)。针对兔真菌感染模型,那他霉素治疗组及交联联合那他霉素治疗组病程约14d,交联治疗组病程约21d;经治疗后,各治疗组均已愈合,各组角膜上皮均无缺损,新生血管较多,角膜内无菌丝;前节照相结果显示,交联联合那他霉素治疗组治疗结果优于其它各治疗组,瘢痕组织较少,角膜愈合较好,病程相对短。结论:角膜胶原交联方法联合那他霉素,可促进角膜愈合,缩短病程,增强抗真菌效果,有望为眼科临床真菌性角膜炎的治疗提供一种新的治疗技术。
简介:目的:研究板层角膜切除术联合那他霉素治疗真菌性角膜溃疡的临床疗效及组织病理学基础。方法:选取2009-12/2011-11真菌性角膜溃疡患者32例32眼,角膜病变未累及内皮层,行角膜板层切除联合那他霉素滴眼治疗,观察记录治疗前后视力、角膜情况、病程、并发症及致病菌种类,对切除组织行组织病理学检查。结果:治疗前视力≤0.05者20眼,~0.3者11眼,〉0.3者1眼。板层切除术后联合那他霉素治疗痊愈28例(87.5%),治愈时间7~32(平均13.2±8.5)d,痊愈时视力≤0.05者5眼,~0.3者8眼,〉0.3者15眼。病情控制不良改行角膜移植术者4例。31例真菌培养阳性(96.9%),其中镰刀菌18例,曲霉菌属8例,链格孢霉3例,未知菌属2例。病理学检查显示溃疡灶中有多量中性粒细胞浸润,过碘酸-希夫(PAS)染色显示角膜组织中菌丝多数位于角膜浅层,并呈与板层胶原纤维平行方向生长,但也有少数呈斜形或垂直生长方式,侵及切除组织全层。不同菌属之间菌丝在角膜中生长方式无明显差异。结论:对于病变未累及全层的真菌性角膜溃疡患者,及时行板层角膜切除术可大大提高那他霉素药物治疗有效性,缩短病程,恢复视力。
简介:AIM:Toinvestigatethepossiblerelationshipbetweentheinfluencingfactorsoccurringbeforeandduringbirthinfull-terminfantsandtheoutcomeofretinopathy.·METHODS:Totally816full-terminfantsadmittedintheneonateintensiveunitofBoaiHospitalofZhongshanbetween1May,2008and30June,2011wereincludedinthestudy.Fundusexaminationwasperformedandevaluatedindividuallyonthemattheageof48hoursafterdelivery,2weeksand1month.Somepossibleriskfactorshappeningprenatallyorduringdeliverysuchaspregnantrelatedhypertension,placentaprevia,placentalabruptionetc,aswellassomeneonatalriskfactorssuchasneonatalasphyxia,hypoxic-ischemicencephalopathy(HIE),lowbirthweightetc,wererecordedandevacuated.Thentheeffectoftheriskfactorsoffull-terminfantsonretinopathywasstudied.·RESULTS:Theincidenceofretinalhemorrhageoffull-terminfantswithprenatalpregnantrelatedhypertension(PRH)ofthemother(43.6%)wassignificantlyhigherthanthatoffull-terminfantswithout(8.0%).(P<0.001).Theincidenceofretinalhemorrhageoffull-terminfantswithneonatalasphyxiaand/orhypoxic-ischemicencephalopathy(HIE)(29.3%)wassignificantlyhigherthanthatofthosewithout(15.7%),butcorrelationwasnotfoundbetweentheseverityofretinahemorrhageandthedegreeofhypoxicdisease.Apalecolorofopticdiscwasassociatedwithalowbirthweightoffull-terminfant.Full-terminfantswithbirthweighlessthan2500ghadasignificanthigherincidenceofretinopathythanthosewithbirthweightequalormorethan2500g(P<0.001).·CONCLUSION:Themaininfluencingfactorswhichleadtoretinopathyofhighriskfull-terminfantsareprenatalfactorssuchasPRH,andsomeneonatalriskfactorssuchasasphyxia,hypoxic-ischemicencephalopathy,andlowbirthweight.
简介:·Descemet’smembranedetachment(DMD)canbeapotentiallyseriouscomplicationofintraocularsurgeryoroculartrauma.Thecauseisnotveryclear.WearetryingtoremindanawarenessofthespectrumofDMDresultingfromtrabeculectomybypresentingacaseofextensiveDMDaftertrabeculectomywhichwassuccessfullyrepaired.
简介:Oculardrugtransportbarriersposeachallengefordrugdeliverycomprisingtheocularsurfaceepithelium,thetearfilmandinternalbarriersoftheblood-aqueousandblood-retinabarriers.Oculardrugdeliveryefficiencydependsonthebarriersandtheclearancefromthechoroidal,conjunctivalvesselsandlymphatic.Traditionaldrugadministrationreducestheclinicalefficacyespeciallyforpoorwatersolublemoleculesandfortheposteriorsegmentoftheeye.Nanoparticles(NPs)havebeendesignedtoovercomethebarriers,increasethedrugpenetrationatthetargetsiteandprolongthedruglevelsbyfewinternalsofdrugadministrationsinlowerdoseswithoutanytoxicitycomparedtotheconventionaleyedrops.Withtheaidofhighspecificityandmultifunctionality,DNANPscanberesultedinhighertransfectionefficiencyforgenetherapy.NPscouldtargetatcornea,retinaandchoroidbysurficialapplicationsandintravitrealinjection.ThisreviewisconcernedwithrecentfindingsandapplicationsofNPsdrugdeliverysystemsforthetreatmentofdifferenteyediseases.
简介:AIM:Toevaluatetheeffectofbrinzolamide-timololfixedcombinationonintraocularpressure(IOP)aftercataractsurgery.METHODS:Thestudyincluded92eyesof87patientswhounderwentcataractsurgeryandintraocularlensimplantation.Patientsscheduledforphacoemulsificationwereassignedto1of2groups.Thetreatmentgroupreceived1dropofbrinzolamide-timololfixedcombinationimmediatelyaftersurgery,andthecontrolgroupreceivednotreatment.TheIOPwasmeasuredpreoperativelyandat2hand24hpostoperatively.RESULTS:ThemeanIOPchangewaslowerinthetreatmentgroupthaninthecontrolgroupat2hpostoperatively.ThedifferencebetweenthemeanIOPvaluesofthetwogroupsat2hpostoperativelywasfoundtobestatisticallysignificant.Twenty-fourhoursafterthesurgery,themeanIOPchangewasstillhigherinthecontrolgroupwhencomparedtothetreatmentgroup.CONCLUSION:ThefixedcombinationbrinzolamidetimololcaneffectivelyreduceIOPaftercataractsurgery.
简介:<正>DearSir,IamProf.BeuyJoobfromSanitation1MedicalAcademicCenter,Bangkok,Thailand.Iwritetodiscusstherecentpublicationonproteomicanalysisindiabeticretinopathy(DR).Liuetal[1]concludedthattheirapproachbytwodimensionalfluorescencedifferencegelelectrophoresis(2D-DIGE)combinedwithmatrix-assistedlaser
简介:·Thetherapeuticeffectofselenium(Se)hasalreadybeenproveninthyroiddiseaseandthyroidassociatedophthalmopathy(TAO).InspiteofclearscientificproofofitsbenefitsinTAO,thereappearstobenoclearagreementamongthecliniciansregardingitsoptimumdose,durationofthetreatment,efficacyandsafetytodate.Inthisreview,theauthorsummarisesthefindingsof135Englishlanguagearticlespublishedonthissubjectoverthepastfourdecadesfrom1973to2013.TheregulationandmetabolismofthyroidhormonesrequireasteadysupplyofSeandrecentstudieshaverevealedseveralpossiblemechanismsbywhichSeimprovestheseverityofthyroiddiseaseandTAO.Thesemechanismsinclude1)inhibitoryeffectofHLA-DRmoleculeexpressiononthyrocytes;2)profoundreductionsofthyroidstimulatinghormone(TSH)receptorantibodies(TSHR-Ab)andTPOantibodies(TPO-Ab);3)preventionofdysregulationofcell-mediatedimmunityandBcellfunction;4)neutralisingreactiveoxygenspecies(ROS)andinhibitionofredoxcontrolprocessesrequiredfortheactivation,differentiationandactionoflymphocytes,macrophages,neutrophils,naturalkillercellsinvolvedinbothacuteandchronicorbitalinflammationinTAO;5)inhibitionofexpressionofproinflammatorycytokinesand6)inhibitionofprostaglandinandleukotrienesynthesis.AnincreasedoxidativestresshasbeenobservedinbothacuteandchronicphasesofthyroiddiseasewithraisedtissueconcentrationsofROS.ThebenefitsofSesupplementationinindividualswithTAOappeartobeproportionatetothedegreeofsystemicactivityofthethyroiddisease.ThemaximalbenefitofSesupplementationisthereforeseeninthesubjectswhoarehyperthyroid.RestorationofeuthyroidismisoneofthemaingoalsinthemanagementofTAOandwhenanti-thyroiddrugsarecombinedwithSe,thepatientswithGraves’disease(GD)andautoimmunethyroiditis(AIT)achievedeuthyroidismfasterthanthosetreatedwithanti-thyroiddrugsalone.SestatusofnormaladulthumanscanvarywidelyandSe
简介:目的:探讨儿童瞬目症BUT情况,为临床治疗提供依据。方法:215例患者均排除全身疾患,检查角膜、结膜、屈光不正等,着重检查BUT,详细了解患者病史,不良生活习惯等,治疗上停用含有防腐剂及激素类滴眼液,避免及纠正不良卫生及生活习惯,心理治疗,合理用眼,矫正屈光不正,给予不含防腐剂的滴眼液点眼,如3g/L艾丽滴眼液3次/d点眼,需用抗生素的给予可乐必妥滴眼液3~4次/d点眼,酌情给予抗病毒及维生素类药物。结果:215例患者BUT小于10s者197例(91.6%)326眼,其中5S以下123例224眼。本组215例病例中经过7~28d治疗,173例(80.5%)治愈,37例(17.2%)好转,5例(2.3%)无效,均未患眼部疾病,且不配合治疗,仍每天看电视或玩电脑游戏2h以上。经治疗BUT正常者192例(89.3%),好转19例(8.8%)无效者4例(1.9%)。随访1~6mo,复发31例,均为长期看电视、玩电脑、习惯揉眼者,BUT检查再次异常者,重复治疗后治愈或好转。结论:泪膜的保持并发挥其生理功能与瞬目动作休息相关,我们认为泪膜稳定性差是瞬目症的另一重要因素,BUT检查在诊治儿童瞬目症中起着关键的作用,它可以正确指导医生合理用药,使患者早日康复,而且简单易行,无痛苦,儿童易接受。我们建议BUT可作为儿童瞬目症的常规检查。
简介:目的研究传入神经物质-谷氨酸在小鼠耳蜗Corti器中的表达。方法应用免疫组化技术简洁而又成功地在光镜下对小鼠游离耳蜗Corti器中谷氨酸进行定位。结果显示小鼠耳蜗内,外毛细胞染色阳性,染色颗粒细而均匀。克服了谷氨酸神经递质用传统常规前包埋染色技术电镜下不能显示的缺点。结论证实谷氨酸是毛细胞的传入性神经递质。
简介:·AIM:Toinvestigatetheantifibroticeffectoffreeze-driedbilayeredfibrin-bindingamnioticmembraneontrabeculectomyinarabbitmodel.·METHODS:Twenty-fourJapanesewhiterabbitswererandomizedintothreegroups:theexperimentalgroup(oculartrabeculectomyincombinationwithfreeze-driedbilayeredfibrin-bindingamnioticmembranetransplantation),thecontrolgroup(oculartrabeculectomyincombinationwithnaturalbilayeredfibrin-bindingamnioticmembrane)andtheblankgroup(singletrabeculectomy).Clinicalobservation,hematoxylin-eosinstaining,Massionstaining,real-timePCRandimmunohistochemistryforα-SMAwereperformedondays7,14,21and30followingsurgery.·RESULTS:Statisticaldifferenceswerenotedinsurvivalanalysisandintraocularpressure(IOP)amonggroupsondays7,14,21and30followingsurgery.Histology,immunoh-istochemistryandreal-timePCRfurtherdemonstratedthattrabeculectomyincombinationwithfreeze-driedbilayeredfibrin-bindingamnioticmembraneresultedingoodwoundhealingandnoscarformation.·CONCLUSION:Self-madefreeze-driedbilayeredfibrin-bindingamnioticmembranemayinhibittheformationofscarringinglaucomaaftertrabeculectomy.·
简介:AIM:Toinvestigatethecharacteristicsandcriterionofgraftrejectioninmicemodel.METHODS:C57BL/6orBALB/cmicecornealgraftsweregraftedontoBALB/chosts.Eachgroupwasdividedintotwosubgroupsaccordingtothecornealopacityscores12daftertransplantation.Thecharacteristicsofopacityandneovascularizationwereobserved.Miceofthe12th,50thdayaftertransplantation,thegraftsbiopsyofmiceinallogeneicgroup1,whichopacityscoreexceed3,werepreparedforhistologicalobservationandthoserestoretransparentwereendothelialstained.RESULTS:Therewasnodifferenceofcornealopacityscoreonthe7thand12thdayafteroperation;thehistologicalresultshadnodisparitybetweensyngeneicgroupandallogeneicgroup.Onthe12thdayaftersurgery,theturbiditycurvewasapparentingraftswithopacityscore<2.Mononuclearcellswereshowningraftswithopacityscorereached3inallogeneicgroup1.Differentrejectionperformancewasobservedintissuesectionsonthe50thdayaftersurgery.CONCLUSION:Grafts,opacityscoreexceeds3fromthe7thtothe12thdayafteroperationcouldnotbejudgedasarejection.Weshouldpaymoreattentiontothevariationofgraftsopacitysince12daftercornealtransplantation.