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AIM:To investigate the quality of life of elderly patients with low vision and its nursing service demand,in order to improve the quality of life of elderly low vision group and provide theory basis.METHODS:A cross-sectional study method,in a tertiary hospital in Fuzhou city elderly patients with low vision 200 cases were as the research object,USES the Chinese version of quality of life scale (CLVQOL),low vision care service demand questionnaire investigation were taken.RESULTS:In elderly patients with low vision life quality score was 54.92±12.11,the nursing service demand score 30.34± 8.93,medium and high demand was of 88％.Quality of life was negatively correlated with nursing service demand value (r=-0.266,P＜0.01).CONCLUSION:The quality of life of elderly patients with low vision was low,nursing service demand is high,especially on visual function recovery training of nursing service requirements.Aging brings important social problems in China,attaches great importance to the elderly care service demand,discussion with precise visual nursing care intervention in low vision group,it is necessary to improve the quality of life.
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·Retinal neovascular disease is not an independent eye disease,which is more common seen in many other eye diseases spontaneously and cause serious damage to vision, such as retinopathy of prematurity, diabetic retinopathy, age-related macular degeneration, retinal central venous obstruction and retina venous inflammation, which present retinal neovascularization. The loss of normal blood vessels structure and function, causing pathological bleeding,oozing,edema and retinal detachment and other pathological changes, they are the main reason for loss of vision, which has become a worldwide blindness disease. At present, the main treatment for the disease include of laser occlusion, vitrectomy, repeated vitreous cavity injection of anti-vascular endothelial growth factor, those treatment has significant curative effect, but cannot prevent relapse of the disease. There is still no long-term effective treatment method nowadays. The emergence of stem cell therapy has provided potential alternative therapies. In this review, the latest application of bone marrow mesenchymal stem cells (BMSCs) in retinal neovascular disease will be discussed and present its migration advantages and promising clinical application prospects.
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·The common feature of retinal neovascularization is the formation of pathological neovascularization. The primary one of endogenous retinal neovascularization factor in current research is vascular endothelial growth factor (VEGF). SFlt-1, the soluble form of splicing in mRNA extracellular region of VEGFR - 1, which is short of intracellular tyrosine kinase domain can only encode the extracellular domain. Therefore, it only can bind with ligands but can not transmit signals, thus preventing the formation of neovascularization. SFlt-1,as a hot research topic in recent years, may provide a new gene therapy method for this disease. This review focus on the mechanism and research progress of sFlt-1 in retinal neovascularization.
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Internal limiting membrane ( ILM) peeling is commonly used in the operation of idiopathic macular hole ( IMH ) surgery. The success of ILM peeling has been greatly improved with the assistance of vital dyes. Currently, several kinds of vital dyes such as indocyanine green ( ICG ) , brilliant blue G ( BBG ) are applied in the ILM staining. However, all of the vital dyes have potential toxicity and side effects on the retina. In recent years, many kinds of dyes and staining improved emerge in endlessly. This paper reports the progress in the application of different colorants in the operation of IMH.
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AIM: To investigate the effectiveness and safety of intravitreal injection of anti-vascular endothelial growth factors (VEGF) drugs to the patients with proliferative diabetic retinopathy before vitrectomy treatment.METHODS: A Meta-analysis.A comprehensive retrieval was conducted using the database including EMbase,the Cochrane Library,Pubmed,CBM,WanFang Database,CNKI and so on.The retrieval time was limited from the building time of database to Jan.2017.The randomized controlled trial was adopted with no requirements on languages.The Jadad scale and Cochrance cooperation were used as the tool of the risk and bias evaluation to analyze the literature quality.Quality estimation of evidence-based medicine on the parameters of each evaluation index was made via GRADEpro Software.The publishing biases of enclosed documents were inspected with funnel plot.At last,the Meta analysis was conducted with Review Manager 5.3.RESULTS: Totally 16 literatures published from 2008-2016 were finally put into randomized controlled trial.A total of 923 cases were included,among which 493 cases were grouped as intravitreal injection of anti-VEGF before the combined operation of PPV group (the experimental group),and 430 cases were involved in simple PPV group (the control group).The results of Meta-analysis show: (1) The probability of intraoperative bleeding was remarkably lower than the control group [OR=0.06,95%CI (0.02,0.15),P<0.01],with statistically significant differences.(2) The duration of operation was obviously shorter than that of the control group[WMD=-29.13,95% CI (-36.95,-21.30),P<0.01],with statistically significant differences.(3) The probabilities of both early and late postoperative vitreous hemorrhage were lower than those of the control group[OR=0.34,95%CI (0.20,0.58),P<0.01],with highly statistically significant differences.(4) The best corrected visual acuity after surgery was no better than that of the control group,[WMD=-0.51(LogMAR),95%CI(-1.10,0.08),P=0.09] with no statistical significance.(5) The occurrence of iatrogenic retinal rupture was lower than that of the control group[OR=0.24,95%CI(0.14,0.40),P<0.01],with statistically significant differences.(6)Among the 493 patients included in the 16 literature,no case of ocular and general adverse effects due to anti-VEGF injections was reported.CONCLUSION: It is effective and safe for the patients with proliferative diabetic retinopathy to inject anti-VEGF drugs into vitreous cavity before vitrectomy.And it can reduce the occurrence of complications during and after surgery,improving the general treatment effects.However,the specific implementation plans,such as the injection does,the interval between the injection and the operation and so on,still need further exploration and perfection.
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AIM: To investigate the expression of connective tissue growth factor (CTGF) and α-SMA in human lens epithelium cell (HLEC) line B3 after transfection by liposome-coated siRNA targeting CTGF.METHODS: HLECs were transfected with small interfering RNA (siRNA) targeting CTGF,labeled with 5`-fluorescein isothiocyanate (5`-FITC) and coated with lipofectamine.The transfection ratio was evaluated via fluorescence intensity.Cell counting kit-8 (CCK-8) assay was performed to assess cytoviability of both non-transfected and transfected HLECs.Quantitative RT-PCR,cell immunochemistry and Western blot analysis were conducted to detect the expression changes of CTGF and α-SMA after transfection.RESULTS: A highly effective transfection ratio was observed in siRNA co-transfected with lipofectamine.The transfection ratio reached 95% at 24h.The proliferation of HLECs was inhibited by siRNA after 72h transfection.The expression of CTGF and α-SMA significantly decreased in HLECs after transfected by CTGF siRNA for 24h.This effect was not found in negative control siRNA.CONCLUSIONS: SiRNA targeting CTGF decreased CTGF and α-SMA expression in HLECs,which is a potential therapeutic strategy for posterior capsular opacification.
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The normal growth of blood vessels is the result of dynamic balance of angiogenic factor and inhibitory factor in vascular tissue.However, when the balance is broken, the growth of new blood vessels will be induced.Endogenous angiogenesis inhibitory factor, is a group of negative feedback molecules produced by the body itself that inhibit angiogenesis.Its function of inhibiting angiogenesis is mainly realized by promoting the binding of angiogenic factor to its receptor, or its downstream angiogenesis signal, or promoting vascular endothelial apoptosis.The study of angiogenesis inhibitory factor has potential clinical significance for the prevention and treatment of retinal neovascularization.Recent studies on retinal neovascularization inhibitory factor are reviewed in this paper.
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The corneal reconstruction is tosurgial recover the structure integrity and corneal function after suffered from various trauma, inflammation and degenerative diseases.The corneal diseases caused millions of people worldwide suffering from eyesight damages and even blindness.At present, the corneal transplant is the main therapy for corneal blindness.However, the shortage in donor corneal issue is a worldwide problem and the failure due to the immunologic rejection of host is common.Nowadays, with the development of tissue culture and bioengineering technology, the application prospect of autologous stem cell transplantation is becoming more and more popular which might replace the allogeneic transplantation, becoming an important clinical treatment of regenerative medicine.Human dental pulp stem cells (hDPSCs) is a class of adult stem cell divided from the third molar teeth.Both hDPSCs and corneal cell are from the cranial nerve in embryonic ectoderm.Extensive researches show that the hDPSCs have the potentialities in corneal cell differentiation without causing immunologic rejection of the recipient.These findings manifested the potentials of hDPSCs in the clinical applications related to ocular surface reconstruction.In this paper, the features and current investigation status of hDPSCs in ocular surface reconstruction are reviewed.
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Abstract?AIM: To investigate the influence on blood-retina barrier after intense light exposure in rats.?METHODS: The rats were randomly divided into light exposure group and control group. Rats in light exposure group were exposed in white light (10000lux, 12h on-off, continuing 1-14d) .Rats in control group were only exposed in natural light.The eyes of the rats in the two groups were removed when the rats in light exposure group acceptted intense light after 1, 3, 7 and 14d.We observed the change of retinal structure using hematoxylin-eosin ( HE ) staining, and observed the change of retinal ultrastructure using electron microscope.We quantified the change of retinal vascular permeability using laser scanning confocal fluorescence microscope and spectrophotometry after perfusion of Evans-blue, to evaluate the change of blood-retinal barrier.?RESULTS: At 1d after intense light exposure, the retinal ultrastructure of rats changed, such as denaturation of photoreceptor cells and falling of membranous disc outer segment and thinning of the outer nuclear layer thickness, and so on;and the longer the rats exposure to intense light, the more serious change of the retinal ultrastructure were found.At 3d later, photoreceptor cells began apoptosis.At 14d later, the outer nuclear layer became thinner obviously, and the number of cells reduce obviously.At 1d after intense light exposure, EB leaked from the retinal vascular, and at 14d later the leaking of EB was more obvious.?CONCLUSION: The photoreceptor cell of the outer nuclear layer of retina will degenerate and apoptosis, and the outer nuclear layer will be thinner, and the structure and function of blood-retinal barrier will be destroied, if the eyes of rats exposed in intense light.
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AIM: To study the changes of brain - derived neurotrophic factor ( BDNF ) expression in gene modified bone marrow mesenchymal stem cells ( BMSC) . ●METHODS:BMSC were divided into blank control group ( without transfected BMSC ) , negative control group ( empty vector without BDNF gene transfected BMSC) and experimental group ( BDNF gene transfected BMSC) . The expression of BDNF mRNA in BMSC was measured by Realtime PCR, and the expression of BDNF in BMSC was measured by ELlSA. ●RESULTS:The BDNF mRNA expressions of 3, 4, 5, 6, 7 and 8-generation BMSC cells in the experimental group were higher than those in the blank control group and negative control group. The differences were statistically significant (P3: F=491. 788, P ●CONCLUSION:Long-term expression of BDNF in BMSC can be enhanced by genetic engineering.
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· Mesenchymal stem cells ( MSCs ) are a population of multipotent stem cells with various neurotrophins from bone marrow which are widely used in tissue, cell repair and alternative research.Recently, some researches have shown that MSCs could enhance the viability of neurons under a pathological circumstance by secreting some neurotrophins. So the neuroprotection of MSCs can provide a new method of the treatment on retinopathy that it possible to promote cells survial and functional recovery.Here we make a brief review on the secretory function of neurotrophin and neuroprotective effects of MSCs on retinal cells and its application in the treatment of retinal disease.
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Diabetic retinopathy ( DR ) due to disturbance of carbohydrate metabolism is the most serious ocular complication in patients with diabetic disease, and diabetic macular edema ( DME) is one of the main causes of vision loss. lt is considered that many factors are involved in DME pathological process. DME is defined as an abnormal thickening of the macular associated with the accumulation of excess fluid in the extracellular space of the neurosensory retina. Nowadays, the main treatment methods of DME include pharmacotherapy, laser photocoagulation and surgery. lnflammatory components within the vascular tissue play an important role in the development of DME, so drug therapy is an important method for DME. ln this review, we summarized the risk factors and the current pharmacotherapy situation of DME.
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· As a member of the stem cells family, mesenchymal stem cells ( MSCs ) have been proved to be effective on the repair of tissue injury. Although the specific mechanism is still unclear, MSCs do have a promising future in retinal disease therapy.The results of the current research are diverse.We still have an urgent and long way to explore the details of MSCs.So it’s significant for further understanding of MSCs to analyze the possible mechanism and influencing factors.
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?Bone marrow mesenchymal stem cells ( BMSCs ) is a kind of adult stem cells mainly enriched in bone marrow, which possesses multiple differentiation potential and can differentiate into trans-germinal layer. lt is easy for BMSC to be isolated and cultured, which has the ability of repairing various tissues with efficient proliferation and expression. BMSC could be used as seed cell for the transplantation therapy of retinal disease because of its properties of immunoregulation and neurotrophin secretion. This review focuses on research progress on retinal protection of BMSCs.
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? Choroidal neovascularization is the primary pathogenesis of neovascularage - related macular degeneration ( nAMD ) , and the role of vascular endothelial growth factor ( VEGF ) in neovascularization has been widely recognized. Currently, drugs target different targets of VEGF have been widely used in the treatment of nAMD. As a subtype of VEGF, placental growth factor ( PlGF) has synergistic effects with VEGF-A on promoting angiogenesis, stimulating the migration of endothelial cell proliferation and mediating immune inflammatory response. There is no expression of PlGF in mature blood vessels so PlGF hashigh specificity. ln this paper, the role of PlGF in the pathogenesis and treatment of nAMD is reviewed.
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Uveitis is a group of inflammatory diseases causing serious impairment of visual function. The precise etiology and pathogenesis remain unclear. lt can be induced by infection, trauma, tumor or autoimmune response, of which autoimmune response is the most common. ln recent years, the cytokines in the process of inflammatory autoimmune diseases role has become one of research hot spots, its role in the pathogenesis and the relationship between the disease activity more and more attention. This article reviews the effects of interleukin, tumor necrosis factor, interferon and transforming growth factor-β in the pathogenesis of uveitis.
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Diabetic retinopathy ( DR ) is one of the common and serious complications of diabetes, which also the main causes of visual impairment in patients with diabetes, and its incidence has been increasing. With the in- depth study of the pathogenesis of DR, through the control of risk factors including blood glucose, blood pressure and lipid, as well as the application of a variety of drugs, the prevention and cure of DR achieved a certain effect. ln this paper, we make a review of the present status and progress in recent years on the DR control risk factors and drug intervention.
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Diabetes mellitus is a metabolic syndrome characterized by hyperglycemia, and is caused by complex interaction between genetic and environmental factors. Diabetes mellitus can lead to various ocular surface disorders, including dry eye, superficial punctuatekeratitis, corneal epithelial defects, and recurrent corneal erosion et al. This review focuses on the domestic and overseas research progress on dry eye in diabetics.
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<p><b>OBJECTIVE</b>To study the retinal ultrastructure of streptozocin (STZ)-induced diabetic rats and the intervention effect of Lycium Barbarum Polysaccharides (LBP).</p><p><b>METHODS</b>The STZ-induced diabetic SD rat model was established. LBP was given to those in the treatment group by gastrogavage. Changes of body weight, blood glucose, and retinal ultrastructure at 24-week were observed.</p><p><b>RESULTS</b>Early retinal changes covered mitochondrion changes, cell degeneration and apoptosis of retinal neurons and neuroglia cells in the diabetic rats. No change of body weight or blood glucose was observed between the LBP group and the diabetic model group (P > 0.05). The ultrastructural changes were obviously relieved by LBP, and limited to the inner nuclear layer.</p><p><b>CONCLUSIONS</b>LBP could obviously relieve pathological changes of mitochondrion, hinder neural cell apoptosis. Its effect might not be achieved by lowering blood glucose. It was expected to be used in preventing and treating early diabetic retinal neuropathy.</p>
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Animais , Masculino , Ratos , Diabetes Mellitus Experimental , Patologia , Retinopatia Diabética , Patologia , Medicamentos de Ervas Chinesas , Farmacologia , Ratos Sprague-Dawley , RetinaRESUMO
Background Marrow mesenchymal stem cells (MSCs) has been successful induced to differentiate into corneal cells,retinal ganglion cells (RGCs) and retinal neuron-like cells in recent years,but there are few studies about MSCs induced into photoreceptor cells and their microenvironment.Objective The aim of this study was to explore the induce and differentiation of bone marrow mesenchymal stem cells (BMSCs) into photoreceptor-like cells in vitro and microenvironment.Methods The second generation of human BMSCs strain and RPE cells strain were cultured and passaged,respectively,and the fourth generation of BMSCs and the third generation of RPE cells were used in the experiment.BMSCs were cocultured using the mesenchymal stem cells medium (MSCM) contained 20 μg/L basic fibroblast growth factor (bFGF),20 μg/L epithelial growth factor (EGF)and 20 μg/L brain derived neurotrophic factor (BDNF) with RPE cells to induce the differentiation of BMSCs in the induced group,and BMSCs were cultured in MSCM only in the control group.The morphology of induced and differentiated cells were observed under the inverted microscope.Inmmunocytochemistry was used in induced for 3-,5-,7-day cells to detect the expression rate of rhodopsin protein for the identification of phenotype of the differentiated cells.RT-PCR was used in induced for 5-,7-day cells to detect the expressions of rhodopsin mRNA and recoverin mRNA.Results Cultured BMSCs grew well with the spindle shape,and passaged RPE cells showed the uniform size and polygon shape with the abundant pigment in the cells.Some induced cells appeared to be the neuron-like cells with round shape and long prominence and the secondary reticular branches.The expression rates of rhodopsinin the cells were (5.83±0.29)％,(20.36±0.32)％ and (29.80±2.30)％ in the third,fifth and seventh day after induce,which were significantly higher than (0.71 ±0.35) ％,(2.56±0.24) ％ and (2.32±0.42) ％ of control cells (t3 d =41.510,t5d =107.290,t7 d =30.036,P＜0.01).The grey scales of rhodopsin mRNA and recoverin mRNA were significantly elevated in the induced and differentiated cells compared with control cells in the fifth and seventh day (rhodopsin mRNA:t5 d =103.506,t7 d =122.584,P＜0.01 ; recoverin mRNA:t5 d =106.674,t7 d =189.992,P＜0.01).Conclusions BMSCs can be successfully induced to differentiate into photoreceptor cells after cocultured by conditioned medium with RPE cells.