玻璃体切除术联合硅油填充术后再发视网膜脱离研究进展

【】：硅油是玻璃体切除术中一种良好的填充物,然而硅油取出后3.5–33%的患者再次发生视网膜脱离。引起再次视网膜脱离的风险因素可能有多种：硅油的种类、视网膜PVR分级、残留玻璃体牵拉、硅油填充时间、巩膜环扎术或视网膜光凝术等。     

玻璃体切除治疗家族性玻璃体淀粉样变性的临床疗效分析

目的评价玻璃体切除术治疗家族性玻璃体淀粉样变性的临床疗效,随访观察术后并发症和复发情况。方法采取玻璃体切除术治疗来自同一家系确诊为家族性玻璃体淀粉样变性的患者8例(11只眼),5例(7只眼)行单纯玻璃体切除术,3例(4只眼)行玻璃体切除联合眼内激光光凝加气体填充术,其中1眼联合行白内障超声乳化吸出及人工晶状体(IOL)植入术。术后所有病例行常规眼部检查和荧光素眼底血管造影(fundus fluorescein angiography,FFA)检查,随访36个月。结果术后FFA显示1例(1只眼)视网膜有少许出血点,1例(1只眼)周边视网膜血管有荧光素的轻微渗漏,其余6例(9只眼)无异常。术后视力:术后3月,大于或等于1.0的4例(6眼),0.6～0.8的3例(4眼),小于或等于0.5的1例(1眼);1年:大于或等于1.0的3例(5眼),0.6～0.8的3例(4眼),小于或等于0.5的2例(2眼)。2年:视力稳定同1年时。术后常规眼部检查:1例(1眼)在术后29个月时发现玻璃体淀粉样变性复发,复发混浊物为灰白色绒状,紧贴视网膜表面,与术前混浊形态相一致,其余7例(10眼)无复发。术后并发症:继发性青光眼1例(1眼)。结论玻璃体切除术是治疗家族性玻璃体淀粉样变性安全、有效的方法,术后能明显改善视力。但术后长期观察可有淀粉样变性复发,并且术后可能会增加发生继发性青光眼的风险。     

微囊化人内皮抑素/293细胞生物学性状及其对人脐静脉内皮细胞增生的抑制作用

目的 观察不同细胞密度的微囊化人内皮抑素/293(hES/293)细胞生物学性状及其对人脐静脉内皮细胞(HUVEC)增生的抑制作用.方法 采用聚电解质络合法制作不同密度微囊化hES/293细胞,分为1×104个/ml组(A组)、1×106个/ml组(B组)、1×108个/ml组(C组);同时将微囊内不包裹hES/293细胞者设为对照组(D组);每组6个样本.培养后1、3、7、14、35 d,锥虫蓝染色计数微囊囊内细胞总数、活细胞数和存活率;噻唑蓝(MTT)比色法检测各组微囊化hES/293细胞的生长情况;酶联免疫吸附试验(ELISA)法检测微囊化hES/293细胞囊外内皮抑素(ES)蛋白释放量.取生长状态良好的HUVEC分别与A、B、C、D组微囊化hES/293细胞共同培养.于共同培养后24、72、120 h,MTT比色法检测微囊化hES/293细胞对HUVEC增生的抑制作用.结果 A、B、C组微囊囊内hES/293细胞总数和活细胞数均随时间延长而增多,囊内细胞存活率于培养后3 d最高.A、B、C组微囊化hES/293细胞生长速率比较,培养后1 d时组间差异无统计学意义(P＞0.05);培养后3 d,A组较B、C组高,差异有统计学意义(P＜0.05);培养后7、14、35 d,B组较A、C组高,差异有统计学意义(P＜0.05).A、B、C组微囊化hES/293细胞囊外Es蛋白释放量比较,培养后1、14 d时组间差异无统计学意义(P＞0.05);培养后3 d,A组较B、C组高,差异有统计学意义(P＜0.05);培养后7、35 d,B组较A组高,差异有统计学意义(P＜0.05).共同培养后24 h,A、B、C组对HUVEC均未表现出抑制作用(P＞0.05);共同培养后72、120 h,A、B、C组均明显抑制HUVEC增生,差异有统计学意义(P＜0.05).结论 细胞密度为1×106个/ml的微囊化hES/293细胞生长稳定、存活率较高,可持续稳定的释放ES蛋白.不同密度的微囊化hES/293细胞均可抑制HUVEC增生.

Abstract：

Objective To observe biological characteristics of microencapsulated human endostatin/293 (hES/293) cells at different density and their inhibitory effects on the proliferation of human umbilical vein endothelial cells (HUVEC). Methods The microencapsulated hES/293 cells at different cellular density of 1 × 104 (group A) , 1 × 106 (group B) and 1 × 108 (group C) cells/ml were made by polyelectrolyte complexometry technology. The empty microcapsules were set as control group (group D). Each group has 6 samples. After 1, 3, 7, 14 and 35 days in culture, the number of total cells, viable cells was counted by trypan blue staining, and the survival fraction was measured. The grow status of hES/293 cells was measured by MTT assay, and the concentration of endostatin protein in supernatant was measured by enzyme linked immunosorbent assay (ELISA). HUVECs were co-cultured with hES/293 cells of group A,B and C. The proliferation of HUVEC at the 24, 72 and 120 hours after co-culture was measured by MTT assay. Results The number of total cells and viable cells were increasing and the survival fraction reached its peak after 3 days in culture in group A, B and C. The growth rate in group A was higher than that in group B and C after 3 days in culture (P＜0.05), but the growth rate in group B was higher than that in group A and C after 7, 14 and 35 days in culture (P＜0.05). The concentration of endostatin protein in the supernatant was the same in group A, B and C after 1 and 14 days in culture (P＞0.05). However, group A had higher endostatin than group B and C after 3 days in culture, group B had higher endostatin higher than group A and C after 7 and 35 days in culture (P＜0.05). The hES/293 cells of group A, B and C had no effects on the proliferation of HUVEC (P＞0.05) after 24 hours co-culture, but can inhibit the proliferation of HUVEC after 72 or 120 hours co-culture (P＜0.05). Conclusions The microencapsulated hES/293 cells at a density of 1 X 106 cells/ml can grow and survive, and release endostatin protein stably.The microencapsulated hES/293 cells at different density all can inhibit the proliferation of HUVEC.     

玻璃体内硅油填充对孔源性视网膜脱离患者黄斑中心凹下脉络膜厚度(SFCT)及眼轴的影响

目的 探讨玻璃体内硅油填充对孔源性视网膜脱离患者黄斑中心凹下脉络膜厚度(SFCT)及眼轴的影响。方法 收集2020年11月至2021年5月在遵义医科大学附属医院眼科确诊为孔源性视网膜脱离的患者31例(31眼)。本研究采用前后自身对照的病例系列研究方法，于术前，硅油填充术后1、3个月，硅油取出术后1、3、6个月测量患者黄斑中心凹厚度(CMT)、SFCT、眼轴长度以及眼压。通过重复测量方差分析和Spearman相关系数分析各指标不同时间点的差异及相关性。结果 硅油填充术后1、3个月时患者CMT与术前比较，差异均无统计学意义(均为P>0.05);硅油取出术后1、3、6个月时患者CMT均厚于术前，差异均有统计学意义(均为P<0.05)。硅油填充术后1、3个月及硅油取出术后1、3、6个月时患者SFCT均小于术前，差异均有统计学意义(均为P<0.05)。硅油填充术后1、3个月时患者眼轴长度大于术前，差异均有统计学意义(均为P<0.05),硅油取出术后1、3、6个月时患者眼轴长度均小于硅油填充术后3个月时，差异均有统计学意义(均为P<0.05)。硅油填充术后3个月时患者...