汉防己甲素滴眼液治疗大鼠角膜移植排斥反应及植片变化

目的:探讨汉防己甲素(Tet)滴眼液治疗实验性角膜移植排斥反应效果及植片变化。方法:建立大鼠角膜移植排斥反应模型,随机分4组:A、B、C、D组为SD-Wistar大鼠行同种异体角膜移植术,SD鼠为受体,Wistar鼠为供体,其中A组为空白对照组,B～D组分别为3,5,10g/L汉防己甲素滴眼液治疗组。术后不同时间裂隙灯显微镜记录及比较各组角膜植片新生血管情况,并观察植片病理学改变。结果:植片内主要为淋巴细胞及巨噬细胞浸润。B、C、D组术后7,14,21,28d时角膜植片水肿、淋巴细胞及巨噬细胞浸润及新生血管明显少于A组(P<0.05)。不同Tet浓度组间比较C组排斥指数最低(P<0.05)。结论:高浓度(10g/L)Tet治疗角膜移植排斥反应时可出现角膜基质水肿及角膜大泡,但5g/L浓度Tet滴眼液可有效抑制角膜移植排斥反应,且无明显毒副作用。     

汉防己甲素滴眼液防治大鼠角膜移植排斥反应的实验研究

目的:探讨汉防己甲素滴眼液防治角膜移植排斥反应效果及最佳用药浓度。方法:建立大鼠角膜移植排斥反应模型,随机分5组:A、B、C、D、E组为SD-Wistar大鼠行同种异体角膜移植术,SD鼠为受体,Wistar鼠为供体,其中A组为空白对照组,B～D组分别为0.3%、0.5%、1.0%汉防己甲素滴眼液治疗组,E组为0.1%地塞米松治疗组。术后不同时间裂隙灯显微镜记录及比较各组角膜植片新生血管情况,并观察植片病理学改变。结果:植片内主要为淋巴细胞及巨噬细胞浸润。B、C、D组术后7d、14d、21d、28d时角膜植片水肿、淋巴细胞及巨噬细胞浸润及新生血管明显少于A组(P<0.05)。术后2周不同Tet浓度组间比较C组排斥指数最低,与E组无统计学差异(P>0.05)。结论:0.5%浓度汉防己甲素滴眼液可有效抑制角膜移植排斥反应。     

人纤溶酶原K5突变体滴眼液对大鼠角膜移植植片存活时间的影响

目的 探讨人纤溶酶原K5突变体(mK5)滴眼液预防大鼠角膜移植排斥反应发生的效果.方法 实验研究.以F344大鼠30只作为供体,Lewis大鼠60只作为受体,建立同种异体角膜移植排斥反应模型.另取15只Lewis大鼠行自体原位角膜移植,即A组为15只F344大鼠自体原位角膜移植.采用完全随机分组设计方案,将60只Lewis大鼠(60只右眼)分为B、C、D及E组.术后术眼4次/d滴眼液,每次1滴,A组和B组滴生理盐水,C组和D组滴mK5滴眼液,浓度分别为5 mg/L和10 mg/L,E组给予0.1%地塞米松滴眼液,连续用药14 d.根据Holland排斥反应评分标准,判断术后植片排斥情况.比较各组角膜植片的平均存活时间,并观察各时间点角膜新生血管生长情况,计算其面积.术后第14天,对各组大鼠角膜植片做组织学检查.采用方差分析和SNK-q检验对以上所得结果进行统计学分析.结果 B、C、D、E组植片平均存活时间分别为(9.3±2.1)、(21.1±7.3)、(23.5±10.8)及(28.2±19.1)d;C、D组分别与B组比较,差异有统计学意义(q=10.24,13.47:P<0.05);E组植片存活情况较C、D组好,但组间比较,差异无统计学意义(q=2.54,1.49;P>0.05).术后A、B、C、D及E组角膜新生血管开始出现的时间分别为(3.1±0.8)、(2.6±0.5)、(6.4±0.5)、(7.8±0.7)及(5.3±1.0)d;C、D、E组与A组比较(q=31.58,51.21,19.98;P<0.05);C、D、E组也较B组明显延长(q=43.87,67.14,24.53;P<0.05);C、D及E组两两组间比较差异有统计学意义(q=11.41,20.37,9.67;P<0.05).术后C、D组角膜新生血管的生长面积明显较B组少(q=30.76,62.14;P<0.05),且与E组比较差异有统计学意义(q=15.20,25.64;P<0.05).病理学检查显示,B组角膜植片可见大量炎性细胞浸润和角膜新生血管形成,而C组与D组植片炎性反应较轻,无明显新生血管形成.结论 mK5滴眼液可抑制同种异体大鼠角膜移植术后新生血管的生成,延缓角膜移植排斥反应的发生.     

Sustained intraocular rapamycin delivery effectively prevents high-risk corneal allograft rejection and neovascularization in rabbits

PURPOSE: To evaluate the immunosuppressive and antiangiogenic activities of an intraocular rapamycin (RAPA) drug delivery system (DDS) in a rabbit model of high-risk penetrating keratoplasty. METHODS: Forty New Zealand White rabbits with corneal neovascularization underwent allograft cornea transplantation and were randomly divided into four groups: a control group, a glycolide-co-lactide-co-caprolactone copolymer (PGLC)-implanted group, a RAPA eye drop group, and a RAPA-PGLC DDS-implanted group. Graft survival, corneal neovascularization, and RAPA concentration in the aqueous humor were monitored for 90 days. Corneal grafts were also examined by in situ hybridization and immunohistochemistry for proinflammatory gene expression. RESULTS: In the control and PGLC groups, graft rejection occurred within 3 weeks of keratoplasty. In the RAPA eye drop and RAPA-PGLC groups, corneal rejection was significantly delayed, and neovascularization was markedly inhibited. Median graft survival times were 36 and >90 days in the eye drop and RAPA-PGLC groups, respectively. Mean RAPA concentrations in the aqueous humor were 10.7 ng/mL, 12.0 ng/mL, 9.2 ng/mL, and 7.0 ng/mL in the RAPA-PGLC group 2, 4, 8, and 12 weeks after surgery, respectively. By contrast, RAPA was undetectable in the aqueous humor in the eye drop group. High levels of IL-2R, MCP-1, TNF-alpha, and VEGF were detected in the corneal grafts of the control and PGLC groups but not in those of the RAPA-treated groups. CONCLUSIONS: RAPA-PGLC DDS and RAPA eye drops can significantly prolong the survival of allografts at high risk and inhibit corneal neovascularization. However, RAPA-PGLC DDS is far more effective than RAPA eye drops in preventing corneal graft rejection.     

前房植入环孢素A缓释系统抑制鼠高危角膜移植术后的免疫排斥反应

目的　探讨前房内植入环孢素A缓释系统 (cyclosporineAdrugdeliverysystem ,CsADDS)抑制高危角膜移植术后免疫排斥反应的有效性和可行性。方法　 (1)对 6 0只Wistar大鼠 (6 0只眼 )用缝线法诱导角膜新生血管增生。 (2 )将发生角膜新生血管化的 4 0只Wistar大鼠 (40只眼 )随机分为4组 :对照组 ,1%CsA滴眼组 ,CsADDS结膜下植入组 ,CsADDS前房内植入组。每组均接受同种异系(Spregue Dawley大鼠 )角膜供体 ,行穿透性角膜移植术 ,术后比较各组大鼠免疫排斥反应发生的时间 ,并定期检测各组大鼠房水中CsA的浓度。 (3)正常Wistar大鼠 8只 (16只眼 ) ,随机分为 2组 ,分别在结膜下和前房内植入CsADDS ,术后 2和 4周行眼的组织病理学检查。结果　 (1) 5 1只Wistar大鼠 (5 1只眼 )经角膜基质缝线 ,成功诱导角膜新生血管增生。 (2 ) 4组共 4 0只Wistar大鼠角膜移植术后免疫排斥反应的发生时间分别为 :对照组 (8 2 0± 1 4 8)d ,1%CsA滴眼组 (10 6 0± 1 90 )d ,CsADDS结膜下植入组 (11 4 0± 2 5 0 )d ,CsADDS前房内植入组 (17 0 0± 6 0 5 )d。房水中CsA浓度均值分别为 :对照组 0 μg/L ;1%CsA滴眼组 (47 90± 3 4 8) μg/L ;CsADDS结膜下植入组术后 1、2、4周 ,房水中CsA浓度均值分别为 (5 9 0 0± 3 6 6 ) μg/     

雷帕霉素抑制大鼠角膜移植免疫排斥反应的实验研究

目的探讨雷帕霉素(RAPA)对大鼠角膜移植排斥反应的防治效果。方法以SD大鼠为供体,Wistar大鼠为受体建立角膜移植实验模型。采用完全随机分组设计方案,将68只Wistar鼠(68只眼)随机分为4组,A组为Wistar鼠自体原位角膜移植,B、C、D组为SDWistar鼠之间进行同种异体角膜移植。术后灌胃给药,A组和B组给予空白液,C组和D组分别给予RAPA(3mg·kg-1·d-1)和环孢霉素A(CsA)(10mg·kg-1·d-1),连续用药12d。根据Holland排斥反应评分系统,判断术后植片排斥情况。比较各组角膜植片的平均存活时间和植片存活率。采用广义估计方程对角膜的新生血管评分进行统计学分析。术后14d,对各组角膜进行组织学检查。结果RAPA组发生排斥反应的时间明显延迟,同种异体移植对照组植片平均存活时间(MST)为(11.0±1.5)d,RAPA组MST为(36.1±14.9)d,两组比较差异有统计学意义(P<0.05)。RAPA组角膜植片存活情况较CsA组好,但两组植片存活率比较差异无统计学意义(P>0.05)。RAPA组术后角膜新生血管的生长明显低于异体移植对照组(P<0.05)和CsA组(P<0.05)。组织学检查证实,术后14d,RAPA组角膜植片未见明显淋巴细胞浸润。结论口服RAPA能够延缓大鼠角膜移植排斥反应的发生,并能够抑制术后新生血管的生成。     

Effect of vitamin A on the conjunctival goblet cells of rat after corneal transplantation

AIM: To investigate the effect of vitamin A on the conjunctival goblet cells of rat after corneal transplantation. · METHODS: Rat graft rejection models of corneal transplant- ation were established. SD rats were receptor and Wistar rats were donors. After corneal allografts were performed, 48 SD rats were randomly divided into three groups, 16 rats in each group. Group A was blank control group; group B was treated by oculotect gel (containing vitamin A); group C was treated by 1g/L dexamethasone eyedrops. Besides, group D was normal unoperated eyes. Slit-lamp microscope was employed to record and compare rejection index (RI) of corneal transplantation. By HE, PAS staining of conjunctival histological sections and image analysis system, the number and morphology of conjunctival goblet cells were observed and analyzed between operation group and normal group. · RESULTS: The HE, PAS staining detection showed that the number of conjunctival goblet cells in oculotect gel group, 1g/L dexamethasone eyedrops group and control group is lower than that in normal group after surgery (P <0.01). The number of conjunctival goblet cells in oculotect gel group and 1g/L dexamethasone eyedrops group is higher than that in control group (P <0.05). The number of conjunctival goblet cells in 1g/L dexamethasone eyedrops group is higher than that in oculotect gel group (P <0.05). · CONCLUSION: The results indicate that vitamin A may inhibit the decrease of conjunctival goblet cells after corneal allograft rejection in rats.     

Effects of anti-inflammatory and immunosuppressive drugs on the heterolamellar corneal transplantation in rabbits

We have studied the graft rejection of bovine lamellar cornea transplanted onto the rabbit cornea. In addition, the effect of inhibitors of arachidonic acid metabolism and immunosuppressive agents on this heterolamellar corneal transplant was investigated. The corneal lamellar transplant treated with saline were rejected at 9 +/- 1.4 day with 100% rejection rate. The postsurgical conjunctival hyperemia and edema occurred within 2-3 days. Corneal neovascularization took 5 to 9 days to reach the region of the graft. Intramuscular cyclosporin A (25mg/kg/day) and dexamethasone (0.1%) applied topically for 20 days (t.i.d.) inhibited the corneal opacity, edema, neovascularization and graft rejection. Topical Dexamethasone in the ipsilateral eye prolonged survival of grafts in the contralateral (untreated) eye. Cyclosporin A and dexamethasone probably inhibited the graft rejection process by their immunosuppressive action. Indomethacin and BW755C, respective cyclooxygenase and lipoxygenase inhibitors, applied topically did not inhibit graft rejection process while inhibiting postsurgical inflammatory response.     

雷公藤多甙和FK506滴眼防治大鼠角膜移植免疫排斥反应的比较

目的:观察雷公藤多甙(tripterygiitotorum,TⅡ)及FK506滴眼液局部应用对大鼠角膜移植免疫排斥反应的影响。方法:建立大鼠角膜移植模型,随机按局部滴用药物分组成A,B,C组,用裂隙灯记录及比较各组移植排斥指数,并比较角膜排斥发生时间。分别于术后15d及30d行常规病理学检查。并通过免疫组化检查CD25,CD5+4在角膜植片基质中的表达。结果:0.3g/LTⅡ及0.5g/LFK506抑制角膜移植免疫排斥反应的效应均有效,两者相比效果无显著性差异。HE染色及免疫组化分析可见15d时各有效组角膜植片厚度基本正常,基质中仅有少量CD25,CD5+4阳性细胞表达、淋巴细胞浸润,新生血管少见。结论:TⅡ与FK506疗效近似。具有抑制高危角膜移植免疫排斥反应发生的临床应用价值。     

ICOS共刺激通路参与角膜移植免疫排斥反应的研究

目的研究可诱导共刺激分子（ICOS）共刺激通路与角膜移植急性免疫排斥反应的关系。方法建立大鼠同种异体穿透角膜移植模型,分别于术后7d、14d取植片进行病理学观察,采用RT-PCR法检测植片组织ICOS mRNA的表达情况,免疫组织化学法检测植片组织淋巴细胞ICOS蛋白水平;同时采用流式细胞术检测外周血CD3^＋ICOS^＋T／CD3^＋T的表达情况。均以正常大鼠作为正常对照。结果正常大鼠角膜组织未检测到ICOS蛋白及ICOS mRNA的表达,移植术后植片组织可以检测到ICOS蛋白及ICOS mRNA的表达,且术后14d高于术后7d（P=0．000）;与正常大鼠外周血CD3^＋ICOS^＋T／CD3^＋T的表达相比术后表达皆升高（方差齐性,P=0．156）,且术后14d外周血CD3^＋ICOS^＋T／CD3^＋T的表达高于术后7d的表达（P=0．000）。结论共刺激分子ICOS与角膜移植急性免疫排斥反应密切相关。     

miR-155-5p/SOCS1在大鼠角膜移植排斥反应中的作用

目的 探讨miR-155-5p/细胞因子信号转导抑制物1(SOCS1)在大鼠角膜移植免疫排斥反应中的作用及典必殊能否抑制miR-155-5p/SOCS1 通路延缓排斥反应.方法 建立大鼠角膜移植模型,随机分为对照组、自体移植组、同种异体移植组、同种异体移植+典必殊组(典必殊组).术后每天按Larkin 法行角膜植片排斥...     

NF-κB抑制剂吡咯二硫氨基甲酸酯（PDTC）对角膜移植大鼠角膜组织的影响

目的　探讨核转录因子-κB（nuclear factor-κB，NF-κB）抑制剂吡咯二硫氨基甲酸酯（pyrrolidine dithiocarbamate，PDTC）对角膜移植大鼠角膜组织的影响。方法　取14只Wistar大鼠为供体鼠，提供双眼角膜；28只SD大鼠为受体鼠，均以左眼为术眼，右眼设为正常对照，在显微镜下进行同种异体角膜移植术。手术完成后将28只SD大鼠随机分为3组，对照组（10只）以生理盐水滴左眼，实验组（10只）以1 mg·mL^-1 PDTC滴左眼，均为每天3次，每次1滴，空白组（8只）不做任何处理。术后第1天起，每组分别在术后第5天、第15天、第25天在裂隙灯下观察角膜新生血管的情况并进行评分。对各组角膜植片进行病理学及免疫组织化学染色观察，分析各组大鼠NF-κB及血管内皮生长因子（vascular endothelial growth factor，VEGF）在角膜植片的表达情况。结果　对照组、实验组、空白组角膜移植排斥反应发生的时间分别为（10.80±1.40）d、（23.40±2.30）d、（11.20±2.06）d，实验组排斥反应发生的时间较对照组明显延长，差异有统计学意义（P<0.01）。对照组新生血管一般术后第3~5天出现，并很快进入植片周边，沿缝线处向角膜植片中央粗大生长。实验组新生血管一般术后第5~7天出现，生长速度较慢，血管稀疏。术后不同时间实验组新生血管数、新生血管面积及排斥反应指数均小于对照组，差异均有统计学意义（P<0.05）。角膜移植术后，实验组大鼠角膜上皮基底细胞内出现较多空泡，角膜基质层内出现间质水肿；炎症细胞浸润，并见新生的毛细血管；缝线及切口周围见大量淋巴细胞浸润，部分植片中央发生散在的炎症细胞浸润、角膜上皮部分脱落。对照组角膜植片水肿及炎症细胞的浸润程度较实验组明显增加，且对照组角膜植片显著增厚，基质结构疏松、紊乱；实验组角膜植片相对基质板层结构排列有序，新生血管数在相同时间内明显减少。免疫组织化学染色显示，NF-κB阳性细胞数，实验组为每400倍视野（4.236±0.856）个，较对照组［（18.451±1.234）个］明显减少，差异有统计学意义（P<0.05）；空白组大鼠角膜内鲜有阳性表达。VEGF阳性细胞数，实验组为每400倍视野（2.631±0.238）个，较对照组［（6.254±0.721）个］明显减少，差异有统计学意义（P<0.05）；空白组大鼠角膜内鲜有阳性表达。结论　大鼠进行同种异体角膜移植术后，NF-κB抑制剂PDTC可在一定程度上减少角膜新生血管的生成，抑制角膜移植排斥反应的发生。     

穿透性角膜移植排斥反应危险因素分析

目的:探讨穿透性角膜移植术后植片排斥的危险因素。方法:回顾性分析我院2001-01/2008-01实施穿透性角膜移植发生排斥反应的病例,分析各因素在植片排斥反应病例中所占的比率及各种病例中植片排斥的发生率。结果:总排斥反应率为31.0%,其中普通组为25.5%,高危组为59.4%(P<0.05)。眼部化学伤排斥反应发生率最高48.1%(P<0.05)。高危组发生排斥反应早且病情严重。结论:引起角膜植片排斥的多种因素中,不同疾病的穿透性角膜移植的发生率不同,排斥反应的发生与术前原发病,植床情况,手术设计操作术后预防有密切关系,其中植床新生血管是植片排斥的高危因素。     

Influence of topical anesthetics on oculocardiac reflex and corneal healing in rabbits

AIM: To investigate the incidence of oculocardiac reflex (OCR) with two anesthetic regimens and its prevention using topical anesthetics in a rabbit model, and to explore the effect of topical anesthetics on corneal healing. · METHODS: Forty-eight clinically healthy adult New Zealand white rabbits of either sex were divided into two groups (Group A and B) and anesthetized with either ketamine (Group A, n =24) or propofol (Group B, n =24). he incidence of OCR was recorded in each group with a variety of ocular manipulation with or without the use of topical anesthetics (40g/L lignocaine, 5g/L proparacain, 5g/L bupivacaine). Corneal toxicity and healing following the use of each topical anesthetic was assessed one day after surgery and up to 7 days postoperatively by clinical examination of the eye, histopathology and collagen staining and transmission electron microscopy. · RESULTS: No incidence of OCR was recorded with ocular manipulation under ketamine anesthesia, whereas significant reduction in heart rate (P <0.01) was recorded under propofol anesthesia. Topical anesthetics could successfully prevent the OCR without affecting the corneal healing. · CONCLUSION: Topical anesthetics may be recommended for prevention of OCR without any local adverse effect.     

Corneal graft rejection: a new rabbit model and cyclosporin-A.

In order to test the efficacy of topically applied cyclosporin-A in preventing corneal allograft rejection, existing rabbit models were modified to produce a new model in which the allograft reaction could be consistently initiated solely as a result of corneal transfer without any additional means of sensitisation. With this model, which reflects clinical corneal grafting more closely than many previous models, cyclosporin-A 1% drops applied to the recipient eye 5 times daily for 4 weeks inhibited corneal graft rejection. When cyclosporin-A 1% drops were applied to corneal allografts for 13 weeks, 44% of grafts remained clear 180 days after transplantation. No side effects were observed that could be attributed to topically applied cyclosporin-A.     

诱导供体特异性前房相关免疫偏离对高危角膜移植排斥反应的影响

目的:探讨诱导供体特异性的前房相关免疫偏离(anterior chamber-associated immune deviation,ACAID)对高危角膜移植排斥反应的影响。方法:采用新西兰白兔眼角膜建立碱烧伤眼模型,实验动物随机分为4组,A:正常角膜常规角膜移植组(正常对照组);B:碱烧伤常规角膜移植组(碱烧伤对照组);C:正常角膜诱导ACAID的角膜移植组(正常诱导组)。D:碱烧伤后诱导ACAID的角膜移植组(碱烧伤诱导组)。B,D组进行左眼碱烧伤,烧伤后1mo进行角膜移植。C,D组在角膜移植前2wk于右眼前房注入可溶性抗原以预先诱导供体特异性ACAID。A,B组右眼前房注等量平衡盐溶液。术后记录植片存活时间;对角膜新生血管(corneal neovascularization,CNV)生长情况进行评分;记录移植排斥指数(rejection index,RI);角膜固定、包埋后制作切片行HE染色。结果:A、C组角膜植片长期存活,碱烧伤对照组植片平均存活25.13±0.64d,碱烧伤诱导组角膜植片平均存活时间为38.25±1.28d。与碱烧伤对照组相比,碱烧伤诱导ACAID组角膜植片平均存活时间显著延长,两组植片存活时间的差异具有统计学意义(P=0.00)。结论:诱导供体特异性ACAID可以延长碱烧伤高危眼角膜植片的存活时间。     

同种异体角膜移植后角膜内皮细胞的特征表现及生物学意义

同种异体角膜移植目前仍是治疗角膜疾病最为有效的方法,但术后发生的免疫排斥所引起的角膜炎症反应和血管化,最终导致植片水肿,甚至功能丧失仍是造成手术失败的最主要原因.角膜内皮细胞作为免疫赦免及角膜正常生理功能维系的首要屏障,在眼部系统中占据着至关重要的位置.本文就同种异体角膜移植术后免疫的识别,应答和最终反应的各阶段角膜内皮所呈现的特征改变及生物学意义进行阐述.

Abstract：

Allograft corneal transplantation is currently the most effective and optimum method to treat corneal disease, however it is the immune rejection that the main reason for graft edema caused by vascularization and inflammation of the cornea and surgical failure after transplantation. Corneal endothelial cells occupy a crucial position as immune privilege and the primary barriers for maintaining normal physiological function of eye. In this paper, the various stages (recognition, response and reaction of immune system) of corneal endothelial changes in the morphological and biological characteristics had been presented after allograft corneal transplantation.     

免疫赦免在小鼠角膜移植排斥中的作用研究

目的:阐明同种异体小鼠角膜移植术后免疫排斥反应及免疫赦免的相关性。方法:建立小鼠原位角膜移植及同种异体小鼠角膜移植实验模型。观察原位移植与同种异体移植术后角膜植片发生排斥的情况,对比两种移植术后植片的存活率,了解小鼠角膜移植术后发生排斥反应与免疫赦免反应之间的关系。结果:小鼠原位角膜移植术后植片100%存活;同种异体小鼠角膜移植术后存活率为25%。结论:小鼠角膜移植术后免疫排斥并非绝对,免疫赦免在角膜移植术中发挥重要作用。     

白细胞介素-34在大鼠角膜移植排斥反应中的作用机制

目的　探讨白细胞介素-34（interleukin-34,IL-34）在大鼠角膜移植术后的表达情况以及在免疫排斥反应中的作用。方法　以SD大鼠为供体、Wistar大鼠为受体建立角膜移植实验模型。Wistar大鼠60只按照随机数字表法随机分为3组,B组为自体角膜移植组,C、D组行同种异体角膜移植术。另取10只为正常对照组（A组）。术后B、C组术眼滴泰利必妥眼液,D组术眼滴典必殊眼液。术后各组分别取10只大鼠判断四组角膜植片的存活情况并作生存分析。其余大鼠于术后14 d取术眼角膜植片,行组织病理学、免疫组织化学及RT-PCR检测。结果　生存分析结果提示,A组和B组角膜不发生排斥反应,D组角膜存活时间为（26.00±0.97）d,远高于C组（10.00±1.55）d（P<0.001）。HE染色结果显示,C组角膜组织各层有大量炎性细胞浸润以及新生血管形成,D组仅有少量炎性细胞、新生血管。免疫组织化学结果提示,IL-34蛋白在C组的表达量（0.089 4±0.005 6）明显高于A组（0.037 7±0.002 3）、B组（0.068 4±0.004 4）和D组（0.044 5±0.004 5）的表达量（F=145.21,P＜0.01）,且主要集中在上皮层和基质层。RT-PCR结果提示,IL-34、IL-1β、TNF-α、IL-17A的mRNA 在C组角膜组织中表达水平明显高于A组、B组和D组（均为P<0.05）。结论　IL-34参与了大鼠角膜移植术后的排斥反应,而典必殊可能通过抑制IL-34的表达及相关的信号通路,延缓排斥反应的进展。     

3g/L玻璃酸钠联合角膜绷带镜在翼状胬肉切除术后早期的应用

目的:评价3g/L玻璃酸钠联合角膜绷带镜在翼状胬肉切除术后早期的应用价值。方法:随机双盲对照研究。收集2017-03/2018-03行手术治疗的单眼原发性鼻侧翼状胬肉患者90例90眼,分为A、B、C三组。A组角膜绷带镜+3g/L玻璃酸钠治疗;B组角膜绷带镜+1g/L玻璃酸钠治疗;C组:3g/L玻璃酸钠+包盖治疗。比较三组治疗后眼表刺激症状评分、角膜上皮愈合时间和结膜植片水肿消退时间。结果:术后A组各观察时间点眼表刺激症状评分均低于C组(P<0.001);A组角膜上皮愈合时间(2.08±0.78d)、结膜植片水肿消退时间(4.62±1.17d)均较C组(5.13±2.34、6.42±1.51d)明显缩短(P=0.001、0.002)。A组与B组术后各时间点眼表刺激症状以及结膜植片水肿消退时间均无差异(P>0.05),但A组角膜上皮愈合时间明显缩短(P=0.018)。结论:3g/L玻璃酸钠联合角膜绷带镜在翼状胬肉切除术后早期应用具有协同作用,可以有效缩短角膜上皮愈合时间,缓解刺激症状。