血管抑素抑制兔眼表碱烧伤角膜缘移植术后的角膜血管新生

目的:检测眼表碱烧伤角膜缘移植术后血管抑素抑制角膜新生血管的作用。方法:16只新西兰大白兔双眼制作碱烧伤模型1d后,双眼行角膜缘移植术,术后左眼局部应用血管抑素治疗2周,右眼作对照;观测4周,根据新生血管侵入角膜缘内的范围、角膜混浊与水肿程度进行分级并作统计学处理;同时测量术后7、14、21及28d的眼压。结果:术后4周时,应用血管抑素的左眼的新生血管的评分为1.19±0.10,而对照组为1.63±0.72,统计学处理显示左眼的新生血管较右眼的明显减少(P<0.05),角膜混浊与水肿程度亦明显下降。各时间点各术眼的眼压均在正常范围,无统计学差异。结论:局部应用血管抑素能有效抑制眼表碱烧伤角膜缘移植术后的新生血管增生。     

Distinct craniofacial‐skeletal‐dermatological dysplasia in a patient with W290C mutation in FGFR2

Mutations in the fibroblast growth factor receptor genes (FGFR) have been known to be associated with many craniosynostosis syndromes with overlapping phenotypes. We studied a 15‐year‐old Thai boy with an unspecified craniosynostosis syndrome characterized by multiple suture craniosynostoses, a persistent anterior fontanel, corneal scleralization, choanal stenosis, atresia of the auditory meatus, broad thumbs and great toes, severe scoliosis, acanthosis nigricans, hydrocephalus, and mental retardation. Radiography revealed bony ankyloses of vertebral bodies of T9–12, humero‐radio‐ulnar joints, intercarpal joints, distal interphalangeal joints of fifth fingers, fibulo‐tibial joints, intertarsal joints, and distal interphalangeal joints of the first toes. The patient was a heterozygous for a 870G → T change resulting in a W290C amino acid substitution in the extracellular domain of the fibroblast growth factor receptor 2 gene (FGFR2). This mutation has previously been reported in a patient with severe Pfeiffer syndrome type 2 that is distinct from the craniosynostosis in our patient. These findings emphasize locus, allelic, and phenotypic heterogeneity of craniofacial‐skeletal‐dermatological syndrome due to FGFR2 mutations. © 2002 Wiley‐Liss, Inc.     

Laser induced thermal injury of rabbit cornea and treatment with anti-inflammatory agents

A moderately severe thermal injury of the central cornea of 48 Dutch-belted rabbit eyes was produced with a carbon (CO₂) laser. The lesions were photographed with a slit lamp (SL) camera immediately following the injury and at 1, 2, 4, 7, 14, 21, 30 and 60 days after the exposure. Lesion size, opaqueness, and depth were graded clinically by SL biomicroscopy at the same intervals. No significant differences were found (p 0.05) between groups of eyes treated with flurbiprofen (0.03%), prednisolone acetate (1%), and vehicle control four-times-a-day for three weeks following injury. Additionally, eyes were studied histopathologically at 3 and 60 days following injury by light and transmission electron microscopy, and clinically at 30 and 60 days by endothelial specular microscopy. Important clinical and histopathological findings included coagulative necrosis of the corneal epithelium, epithelial sloughing, fusion of stromal collagen, stromal edema and inflammatory cell infiltration, stromal scar formation, corneal thinning, endothelial hyperplasia and metaplasia, fibrinous anterior chamber reaction with hypopyon, and retrocorneal fibrous membrane formation.     

Ocular pharmacokinetic models of clonidine-3H hydrochloride

A single topical instillation of clonidine-³H HCl solution (0.2%) was administered to the rabbit eye (30 μl) in order to study the drug's ocular pharmacokinetics. Seven different tissues and plasma were excised and assayed for drug over 180min. By 45–60 min pseudoequilibrium is reached for the cornea, iris/ciliary body, and aqueous humor. Thereafter, drug levels in these tissues decline in parallel. The data are fit separately to a physiological model and a classical diffusion model for which seven ocular tissue compartments and a plasma reservoir are constructed for each model. Clearance terms and distribution equilibrium coefficients are determined from the tissue level data and used as parameters in fitting the mass balance differential equations representing the physiological model. The model parameters can also be fit to a 0.4% single dose. In a separate experiment, a topical infusion technique was designed to provide a constant rate input to the cornea until an apparent steady state was reached in aqueous humor at 55 min. Aqueous humor levels were assayed for clonidine over the infusion and postinfusion periods. The physiological model parameters are fit to the topical infusion data and show good agreement between the predicted and experimental data. The classical model is too complex to fit the data to integrated exponential equations primarily because the method of residuals is inadequate in determining a sufficient set of initial estimates. This is overcome by dividing the eight-compartment model into seven fragmental models, each representing one to five compartments. A stepwise procedure is developed in which initial estimates are obtained for each separate fragmental model and refined. The refined parameter values can then be used as initial estimates for the complex model. Differential equations for the complex model are fit simultaneously to tissue levels representing each compartment. By observation, the classical model fit the data more closely than the physiological model. Statistical moment theory is also applied to the topical infusion data to determine ocular pharmacokinetic parameters for clonidine. The calculated values are: corneal absorption rate constantk _a , 0.00139 min^?1; aqueous humor elimination rate constantk ₁₀ , 0.0658min^?1; mean residence timeMRT _d , 35.6 min; apparent steadystate volume of distributionV _ss, 0.530 ml; and ocular clearanceQ _e , 14.9 =μl/min. The fraction absorbed from the single instillation is estimated as 0.0163.     

兔角膜缘上皮细胞体外培养及其生物学特性的初步研究

目的：建立体外培养兔角膜缘上皮细胞的方法,观察其体外生长的生物学特性。方法：应用组织培养的方法,对兔角膜缘上皮细胞进行体外原代和传代培养,用倒置显微镜观察培养的兔角膜缘上皮细胞体外生长的特征,用苏木精-伊红染色、糖原（PAS）染色,细胞角蛋白免疫组化染色和电镜检查的方法对培养细胞进行形态学检查和鉴定。结果：兔角膜缘上皮细胞可以在体外成功的培养传代,原代培养细胞大多48h贴壁,5天后旺盛生长,15天形成单层,传代培养细胞次日贴壁10天形成单层。细胞角蛋白AE1单克隆抗体染色阳性,PAS染色阴性,培养细胞呈多角形,细胞表面具有丰富的微绒毛,细胞之间有桥粒连接,结论：应用组织培养的方法可以成功获得原代和传代培养的兔角膜缘上皮细胞,培养的细胞具有与正常兔角膜上皮细胞相一致的生物学特性。     

准分子激光屈光性角膜切削术治疗近视和近视散光3年疗效分析

目的 :评价准分子激光角膜切削术 (photorefoactivekeratecomy ,PRK)治疗近视、近视散光的远期疗效。方法 :按术前屈光度将 2 0 9例 (3 77例 )屈光度为 - 1 5 0～ 1 6 0D的患者分为二组 ,低中度组 (I组 )为 - 1 5 0～ - 6 0 0D(2 3 8眼 ) ,高度组 (II组 )为 - 6 2 5～ - 1 6 0 0D(1 3 9眼 )。应用美国Visx2 0 /2 0准分子激光仪对上述二组患者行PRK治疗 ,并对患者术后 3年的屈光度、视力、角膜屈光力、角膜厚度、并发症进行随访观察。结果 :I组、II组中屈光度 <± 1D者分别占 94 5 %和 6 1 9% ;≥± 2 0 0D分别占 0 % ,2 3 7%。术后裸眼视力≥ 0 5者在I组、II组中分别占 99 6 %和 79 9% ;≥ 1 0者分别占 85 3 % ,48 2 %。角膜屈光力两组均在术后 6个月稳定 ,角膜上皮下雾状混浊O级在I组、II组分别为1 0 0 %和 98 6 % ,术后眼压两组均正常。结论 :准分子激光屈光性角膜切削术治疗近视、近视散光效果肯定 ,尤对低中度患者疗效更佳     

Targeting NF-κB c-Rel in regulatory T cells to treat corneal transplantation rejection

The relevance of Tregs in the induction of tolerance against corneal allografts has been well established. Although it is well known that the conversion of Tregs into effector-like cells contributes to the loss of corneal immune privilege, the underlying mechanism is still not fully understood. Using heterologous penetrating keratoplasty model, we found that Tregs from corneal allograft rejected mice (inflam-Tregs) exhibit impaired function and characteristics of effector T cells. Further study showed that the expression of NF-κB c-Rel, a key mediator of effector T cell function, was significantly increased in inflam-Tregs. Mechanistic study revealed that elevated NF-κB c-Rel level in inflam-Tregs impaired Treg function through the promotion of inflammatory cytokine production and glycolysis. More importantly, we demonstrated that targeting NF-κB c-Rel was able to improve the immune suppressive function of inflam-Tregs in vitro and enhance the potential of them to suppress corneal transplantation rejection. Therefore, our current study identified NF-κB c-Rel as a key mediator of the conversion of Tregs into effector-like cells when under inflammatory environment.     

丙种球蛋白治疗内眼术后顽固性角膜水肿的临床分析

目的：探讨丙种球蛋白治疗内眼术后顽固性角膜水肿的临床价值。方法：对内眼术后顽固性角膜水肿的18例18只眼均采用人丙种球蛋白治疗。结果：17例17只眼经治疗后,于裂隙灯显微镜下观察,角膜内皮及基质水肿均在3d内完全吸收,视力提高3～5行。1只眼经治疗后,症状有所改善,但病情有反复,属治疗无效。结论：丙种球蛋白治疗内眼术后角膜内皮及基质顽固性水肿有显著疗效。     

带状疱疹神经痛77例临床分析

目的　探讨带状疱疹神经痛的临床特点。方法　分析７７ 例带状疱疹患者神经痛与疱疹关系,症候定位,误诊 原因及治疗转归。结果　神经痛与水疱疹是带状疱疹主要临床表现,以单节段神经节受累为主,多个神经节受累１４ 例（１８２ ％ ） , Ｈｕｎｔ 综合征１１ 例（１４３ ％ ） ;神经痛先于疱疹出现组４０ 例（５２０ ％ ） ,其中２６ 例误诊（６５０ ％ ） ,和神经痛与疱疹同时出 现组比较有极显著差异（ Ｐ ＜ ００１） ,老年人较中青年人更易误诊（ Ｐ ＜ ００５） ,疱疹落痂后遗神经痛２４ 例（３１２ ％ ） ,止痛 与抗病毒治疗有效。结论　 了解神经痛与疱疹呈节段性分布的临床特点,有助于带状疱疹的早期临床诊断与治疗,有利于疾病转归。     

Falsely elevated intraocular pressure due to increased central corneal thickness

· Purpose: To evaluate whether ocular hypertensive subjects have a higher central corneal thickness than other individuals. · Methods: In this prospective study, 48 subjects with ocular hypertension, 63 patients with open-angle glaucoma, 56 nonglaucomatous patients with diabetes mellitus, and 106 control subjects were evaluated. Corneal thickness was measured by ultrasound pachymetry, and intraocular pressure was determined by Goldmann applanation tonometry. · Results: Central corneal thickness was significantly higher in the ocular hypertensive subjects, mean ±S.D., 592±39 μm, than in the patients with glaucoma (536±34 μm), the nonglaucomatous patients with diabetes mellitus (550±31 μm), and the normal subjects (545±33 μm), P<0.001. The three latter groups did not vary significantly in central corneal thickness, P>0.05. · Conclusion: In some individuals with increased transcorneal measurements of intraocular pressure, the cornea is thicker than in subjects with normal intraocular pressure readings or patients with glaucoma. It suggests that in ocular hypertensive subjects, corneal pachymetry should be performed to rule out an abnormally thick cornea as a reason for falsely high measurements of intraocular pressure. Received: 14 April 1998 Revised version received: 10 July 1998 Accepted: 23 July 1998