AIM：To investigate the expression of matrix metalloproteinases 1 and 3（MMP-1 and MMP-3） and their tissue inhibitors of metalloproteinases 1 and 3（ TIMP-1 and TIMP-3） in the conjunctiva of eyes with conjunctivocha...AIM：To investigate the expression of matrix metalloproteinases 1 and 3（MMP-1 and MMP-3） and their tissue inhibitors of metalloproteinases 1 and 3（ TIMP-1 and TIMP-3） in the conjunctiva of eyes with conjunctivochalasis（CCh）.METHODS：The conjunctival tissue was obtained from the CCh patients and controls,the MMPs/TIMPs expression concentration was determined by enzyme-linked immunosorbent assay（ELISA） and immunofluorescence staining.The expression levels of MMPs/TIMPs in the CCh fibroblasts were determined by analyzing its concentration in the cellular supernatant that was abstracted from the in vitro cultured CCh fibroblasts.RESULTS：MMP-1 and MMP-3 levels determined by ELISA were both significantly higher in the CCh group than that in the control group（P= 0.042,0.022,respectively）,so was the levels of TIMP-1（P= 0.010）.No significant difference in the expression of TIMP-3 in conjunctiva was found between the two groups（P= 0.298）.The expression of MMP-1 and MMP-3 were both up-regulated significantly in the CCh group（P= 0.040,0.001,respectively） on immunofluorescence staining.MMP-1 and MMP-3 expression in the fibroblasts were both significantly higher in the CCh group than that in the control group（P= 0.027,0.001,respectively）,while neither the TIMP-1 nor TIMP-3 expression was significantly different between the two groups（P= 0.421,0.237,respectively）.CONCLUSION：The overexpression of MMP-1 and MMP-3 in conjunctival tissue and fibroblasts may play an important role in the pathogenesis and development of CCh.展开更多
AIM： To explore a feasible method on the establishment of an animal model of conjunctivochalasis （CCH）. METHODS： Twelve clean-grade New Zealand white rabbits were divided into four groups （n=3/group）： the contr...AIM： To explore a feasible method on the establishment of an animal model of conjunctivochalasis （CCH）. METHODS： Twelve clean-grade New Zealand white rabbits were divided into four groups （n=3/group）： the control group （one received no interventions, and the others underwent subconjunctival injection of sterile water）, the matrix metalloproteinases （MMPs） group （administered subconjunctival injection of MMP-3）, the aging group （administered subcutaneous injection of D-galactose）, the tumor necrosis factor-α （TNF-α） solution group （administered eye drops of TNF-α）. Anterior segment photography, conjunctival tissue light microscopy and transmission electron microscopy （TEM） were performed after 12wk. RESULTS： Among all groups, the MMPs group had the following changes： the looser connection between the inferior bulbar conjunctiva and sclera; the more disordered collagen fibers （Trichrome staining） and the broken elastic fibers （Aldehyde-fuchsin staining）; the focal necrosis of fibroblasts （TEM）. CONCLUSION： Administration of MMPs may be a feasible method for the establishment of an animal model of CCH.展开更多
This study investigated the potential role of MAPK signaling pathways in conjunctivochalasis(CCH). Twenty loose conjunctival biopsy samples from 20 CCH and 15 conjunctival biopsy samples from 15 normal controls(CON) w...This study investigated the potential role of MAPK signaling pathways in conjunctivochalasis(CCH). Twenty loose conjunctival biopsy samples from 20 CCH and 15 conjunctival biopsy samples from 15 normal controls(CON) were collected. The conjunctival fibroblasts were cultured in vitro. Immunofluorescence, ELISA, Western blot and reverse transcription-polymerase chain reaction(RT-PCR) were used. Our results showed that the expression of p-ERK, p-JNK, and p-p38 in CCH conjunctiva was significantly higher than that in CON group. The expression of p38 MAPK, JNK, and ERK proteins in CCH fibroblasts was significantly higher than that in CON group. The total expression of MAPK m RNA in CCH fibroblasts was significantly higher than that in CON group. The activated forms of p38 MAPK, JNK, and ERK proteins and m RNAs might up-regulate the expression of MMPs in CCH loose conjunctival tissue and fibroblasts, causing the degradation of collagen fibers and elastic fibers and promoting the occurrence of CCH. Our results deepen the understanding of CCH pathological mechanism.展开更多
The Pub Med,MEDLINE databases and China National Knowledge Infrastructure（CNKI）were searched for information regarding the etiology and pathogenesis of conjunctivochalasis（CCh）and the synthesis and degradation of ...The Pub Med,MEDLINE databases and China National Knowledge Infrastructure（CNKI）were searched for information regarding the etiology and pathogenesis of conjunctivochalasis（CCh）and the synthesis and degradation of elastic fibers.After analysis of the literature,we found elastic fibers was a complex protein molecule from the structure and composition;the degradation of elastic fibers was one of the histopathological features of the disease;the vast majority of the factors related to the pathogenesis of CCh ultimately pointed to abnormal elastic fibers.By reasonably speculating,we considered that abnormal elastic fibers cause the conjunctival relaxation.In conclusion,we hypothesize that elastic fibers play an important role in the pathogenesis of CCh.Studies on the mechanism of synthesis,degradation of elastic fibers are helpful to clarify the pathogenesis of the disease and to find effective treatment methods.展开更多
AIM:To determine the efficacy and safety of pedicled conjunctival lacrimal duct reconstruction in the treatment of severe obstruction of superior and inferior lacrimal canaliculi with conjunctivochalasis.METHODS:This ...AIM:To determine the efficacy and safety of pedicled conjunctival lacrimal duct reconstruction in the treatment of severe obstruction of superior and inferior lacrimal canaliculi with conjunctivochalasis.METHODS:This study was per formed as a retrospective analysis of patients who received conjunctival dacryocystorhinostomy with pedicled conjunctival flap reconstruction combined with tube intubation due to severe superior and inferior lacrimal canalicular obstruction with conjunctivochalasis from January 2019 to October 2019.The clinical data included the degree of preoperative epiphora and postoperative relief,preoperative examination of lacrimal duct computed tomography and ultrasound biomicroscopy,postoperative evaluation of lacrimal duct function by chloramphenicol taste and fluorescein dye disappearance test,etc.Syringing was carried out to determine the reconstruction and patency of the lacrimal duct.RESULTS:All 9 patients(9 eyes)had severe canalicular obstruction with conjunctivochalasis.The patients included 4 males and 5 females aged between 47–65y with an average age of 52.2±6.7y.At 3mo follow-up,the tube was removed and the patients were followed for a further 3mo.After tube removal,6 patients showed no epiphora.These patients also had positive chloramphenicol tastes and normal fluorescein dye disappearance test results.Two patientshad epiphora.Also,syringing showed partial patency of the reconstructed lacrimal duct.One patient had no improvement in epiphora with negative chloramphenicol taste and fluorescein dye disappearance test results and obstruction of the reconstructed lacrimal duct.The total effective rate of the operation was 8/9,with no serious complications.CONCLUSION:Pedicled conjunctival lacrimal duct reconstruction conjunctival dacryocystorhinostomy is safe and effective for superior and inferior canalicular obstruction with conjunctivochalasis.展开更多
Background Different diagnostic and grading systems of conjunctivochalasis have resulted in apparent disparity between the prevalence rates of recent population-based studies.This study aimed to investigate the dispar...Background Different diagnostic and grading systems of conjunctivochalasis have resulted in apparent disparity between the prevalence rates of recent population-based studies.This study aimed to investigate the disparity between 4-level system cited from Meller and Tseng in 1998 （abbreviated here as Meller＇s system） and 5-level system modified from Meller＇s system cited from Zhang and associates （abbreviated here as Zhang＇s system） regarding the diagnosis and the patients＇ preferences for the treatment of conjunctivochalasis in the general population.Methods A total of 546 senile residents living in the Guiyangyuan community of Shanghai,China,participated in the study.The diagnostic criteria for conjunctivochalasis were based on two diagnostic grading systems：Meller＇s system and Zhang＇s system,which was modified from Meller＇s system.The participants＇ preference regarding medical treatment for conjunctivochalasis was determined according to the response to a question.One year later,a follow-up interview determines whether the patient had undergone surgery for conjunctivochalasis.Results With Meller＇s system,398 participants were confirmed as having conjunctivochalasis,and the prevalence rate was 72.89％.According to Zhang＇s system,only 213 participants were diagnosed as having conjunctivochalasis,and the prevalence rate was 39.01％.A total of 109 eyes underwent medical treatment or surgery for conjunctivochalasis in the following year,including eight eyes that were diagnosed as grade Ⅱ and 101 eyes that were diagnosed as grade Ⅲ according to Meller＇s system and five eyes that were diagnosed as grade Ⅰ,55 eyes that were diagnosed as grade Ⅱ,31 eyes that were diagnosed as grade Ⅲ,and 18 eyes that were diagnosed as grade Ⅳ according to Zhang＇s system.Conclusion Diagnoses of conjunctivochalasis using Zhang＇s system are more consistent with patient requests and the medical treatment strategies used than diagnoses made using Meller＇s system.展开更多
Background The crescent excision of the inferior bulbar conjunctiva has been advised as a surgical procedure in the management of conjunctivochalasis refractory to medical treatments. However, it is difficult for this...Background The crescent excision of the inferior bulbar conjunctiva has been advised as a surgical procedure in the management of conjunctivochalasis refractory to medical treatments. However, it is difficult for this procedure to design how much conjunctival tissue should be excised. This study aimed to present a quantitative Iocator for conjunctiva resection and evaluate its effect on the treatment of conjunctivochalasis （CCh）. Methods Poly β-hydroxyethyl methacrylate resin/β-hydroxyethyl methacrylate （HEMA, water gel） was used as the material to make the quantitative Iocator which was designed to suit the specific patient. Forty-six patients with bilateral symptomatic CCh were included in this prospective study. Of the patients, while the right eye underwent the popularly used crescent-shaped conjunctiva resection （group I）, the left eye was treated with conjunctiva resection assisted by the quantitative Iocator （group II）. International Ocular Surface Disease Index （OSDI）, scores of remnant conjunctiva fold, complications and conjunctival cut healing, height of tear meniscus, tear break-up time （BUT）, and time of surgery were evaluated. Tasting chloromycetin test （TCT） was used to evaluate how the lacrimal duct worked. Results OSDI in group II （8.82±2.36） was significantly lower than that in group I （14.67±2.21） （t=12.22, P 〈0.01）. The amount of conjunctiva fold remaining in group II was less than that in group I. Scores of remnant conjunctiva fold in group I were significantly higher than those in group II （t=31.85, P 〈0.01）. While evaluation scores of conjunctival cut healing in group I were lower than those in group II, scores of complication in group I were significantly higher than those in group II at 8 weeks after surgery （t=89.60, P 〈0.01）. There was no significant difference in eyes with normal BUT （X^2=0.031, P=0.985） between the two groups, as the case was in eyes with positive TCT （X^2=0.14, P=0.930） and in eyes with normal height of tear meniscus （X^2=0.48, P=0.780）. Mean surgery time in group II （（17.11±2.08） minutes） was significantly shorter than that in group I （（25.22±4.78） minutes） （t=13.84, P 〈0.01）. Conclusion A quantitative Iocator can be used as an effective, safe, and less time-consuming instrument to facilitate conjunctival excision for symptomatic CCh treatment.展开更多
基金Supported by Shanghai Municipal Health and Family Planning Commission Project(No.20124108)Putuo District of Shanghai Independent Innovation Research Foundation(No.2013PTKW009)
文摘AIM：To investigate the expression of matrix metalloproteinases 1 and 3（MMP-1 and MMP-3） and their tissue inhibitors of metalloproteinases 1 and 3（ TIMP-1 and TIMP-3） in the conjunctiva of eyes with conjunctivochalasis（CCh）.METHODS：The conjunctival tissue was obtained from the CCh patients and controls,the MMPs/TIMPs expression concentration was determined by enzyme-linked immunosorbent assay（ELISA） and immunofluorescence staining.The expression levels of MMPs/TIMPs in the CCh fibroblasts were determined by analyzing its concentration in the cellular supernatant that was abstracted from the in vitro cultured CCh fibroblasts.RESULTS：MMP-1 and MMP-3 levels determined by ELISA were both significantly higher in the CCh group than that in the control group（P= 0.042,0.022,respectively）,so was the levels of TIMP-1（P= 0.010）.No significant difference in the expression of TIMP-3 in conjunctiva was found between the two groups（P= 0.298）.The expression of MMP-1 and MMP-3 were both up-regulated significantly in the CCh group（P= 0.040,0.001,respectively） on immunofluorescence staining.MMP-1 and MMP-3 expression in the fibroblasts were both significantly higher in the CCh group than that in the control group（P= 0.027,0.001,respectively）,while neither the TIMP-1 nor TIMP-3 expression was significantly different between the two groups（P= 0.421,0.237,respectively）.CONCLUSION：The overexpression of MMP-1 and MMP-3 in conjunctival tissue and fibroblasts may play an important role in the pathogenesis and development of CCh.
基金Supported by the Key Medical Discipline Project of Shanghai Municipal Health Bureau-Ophthalmology(No.ZK2015A20)the Health System Independent Innovation Science Foundation of Shanghai Putuo District(No.2015PTKW001)Plateau Science,Integrated Traditional Chinese and Western Medicine,Shanghai University of Traditional Chinese Medicine
文摘AIM： To explore a feasible method on the establishment of an animal model of conjunctivochalasis （CCH）. METHODS： Twelve clean-grade New Zealand white rabbits were divided into four groups （n=3/group）： the control group （one received no interventions, and the others underwent subconjunctival injection of sterile water）, the matrix metalloproteinases （MMPs） group （administered subconjunctival injection of MMP-3）, the aging group （administered subcutaneous injection of D-galactose）, the tumor necrosis factor-α （TNF-α） solution group （administered eye drops of TNF-α）. Anterior segment photography, conjunctival tissue light microscopy and transmission electron microscopy （TEM） were performed after 12wk. RESULTS： Among all groups, the MMPs group had the following changes： the looser connection between the inferior bulbar conjunctiva and sclera; the more disordered collagen fibers （Trichrome staining） and the broken elastic fibers （Aldehyde-fuchsin staining）; the focal necrosis of fibroblasts （TEM）. CONCLUSION： Administration of MMPs may be a feasible method for the establishment of an animal model of CCH.
基金Supported by the Research Project of Health and Family Planning Commission in Shanghai(No.201840196)Yingcai Program of Putuo Hospital(No.2017202B)Yuying Program of Putuo Hospital(No.2016219A)
文摘This study investigated the potential role of MAPK signaling pathways in conjunctivochalasis(CCH). Twenty loose conjunctival biopsy samples from 20 CCH and 15 conjunctival biopsy samples from 15 normal controls(CON) were collected. The conjunctival fibroblasts were cultured in vitro. Immunofluorescence, ELISA, Western blot and reverse transcription-polymerase chain reaction(RT-PCR) were used. Our results showed that the expression of p-ERK, p-JNK, and p-p38 in CCH conjunctiva was significantly higher than that in CON group. The expression of p38 MAPK, JNK, and ERK proteins in CCH fibroblasts was significantly higher than that in CON group. The total expression of MAPK m RNA in CCH fibroblasts was significantly higher than that in CON group. The activated forms of p38 MAPK, JNK, and ERK proteins and m RNAs might up-regulate the expression of MMPs in CCH loose conjunctival tissue and fibroblasts, causing the degradation of collagen fibers and elastic fibers and promoting the occurrence of CCH. Our results deepen the understanding of CCH pathological mechanism.
基金Supported by the Key Medical Discipline Project of Shanghai Municipal Health Bureau-Ophthalmology(No.ZK2015A20)the Health System Independent Innovation Science Foundation of Shanghai Putuo DistrictPlateau Science,Integrated Traditional Chinese and Western Medicine,Shanghai University of Traditional Chinese Medicine
文摘The Pub Med,MEDLINE databases and China National Knowledge Infrastructure（CNKI）were searched for information regarding the etiology and pathogenesis of conjunctivochalasis（CCh）and the synthesis and degradation of elastic fibers.After analysis of the literature,we found elastic fibers was a complex protein molecule from the structure and composition;the degradation of elastic fibers was one of the histopathological features of the disease;the vast majority of the factors related to the pathogenesis of CCh ultimately pointed to abnormal elastic fibers.By reasonably speculating,we considered that abnormal elastic fibers cause the conjunctival relaxation.In conclusion,we hypothesize that elastic fibers play an important role in the pathogenesis of CCh.Studies on the mechanism of synthesis,degradation of elastic fibers are helpful to clarify the pathogenesis of the disease and to find effective treatment methods.
基金Supported by Dalian Medical Science Research Project (No.1811048)。
文摘AIM:To determine the efficacy and safety of pedicled conjunctival lacrimal duct reconstruction in the treatment of severe obstruction of superior and inferior lacrimal canaliculi with conjunctivochalasis.METHODS:This study was per formed as a retrospective analysis of patients who received conjunctival dacryocystorhinostomy with pedicled conjunctival flap reconstruction combined with tube intubation due to severe superior and inferior lacrimal canalicular obstruction with conjunctivochalasis from January 2019 to October 2019.The clinical data included the degree of preoperative epiphora and postoperative relief,preoperative examination of lacrimal duct computed tomography and ultrasound biomicroscopy,postoperative evaluation of lacrimal duct function by chloramphenicol taste and fluorescein dye disappearance test,etc.Syringing was carried out to determine the reconstruction and patency of the lacrimal duct.RESULTS:All 9 patients(9 eyes)had severe canalicular obstruction with conjunctivochalasis.The patients included 4 males and 5 females aged between 47–65y with an average age of 52.2±6.7y.At 3mo follow-up,the tube was removed and the patients were followed for a further 3mo.After tube removal,6 patients showed no epiphora.These patients also had positive chloramphenicol tastes and normal fluorescein dye disappearance test results.Two patientshad epiphora.Also,syringing showed partial patency of the reconstructed lacrimal duct.One patient had no improvement in epiphora with negative chloramphenicol taste and fluorescein dye disappearance test results and obstruction of the reconstructed lacrimal duct.The total effective rate of the operation was 8/9,with no serious complications.CONCLUSION:Pedicled conjunctival lacrimal duct reconstruction conjunctival dacryocystorhinostomy is safe and effective for superior and inferior canalicular obstruction with conjunctivochalasis.
文摘Background Different diagnostic and grading systems of conjunctivochalasis have resulted in apparent disparity between the prevalence rates of recent population-based studies.This study aimed to investigate the disparity between 4-level system cited from Meller and Tseng in 1998 （abbreviated here as Meller＇s system） and 5-level system modified from Meller＇s system cited from Zhang and associates （abbreviated here as Zhang＇s system） regarding the diagnosis and the patients＇ preferences for the treatment of conjunctivochalasis in the general population.Methods A total of 546 senile residents living in the Guiyangyuan community of Shanghai,China,participated in the study.The diagnostic criteria for conjunctivochalasis were based on two diagnostic grading systems：Meller＇s system and Zhang＇s system,which was modified from Meller＇s system.The participants＇ preference regarding medical treatment for conjunctivochalasis was determined according to the response to a question.One year later,a follow-up interview determines whether the patient had undergone surgery for conjunctivochalasis.Results With Meller＇s system,398 participants were confirmed as having conjunctivochalasis,and the prevalence rate was 72.89％.According to Zhang＇s system,only 213 participants were diagnosed as having conjunctivochalasis,and the prevalence rate was 39.01％.A total of 109 eyes underwent medical treatment or surgery for conjunctivochalasis in the following year,including eight eyes that were diagnosed as grade Ⅱ and 101 eyes that were diagnosed as grade Ⅲ according to Meller＇s system and five eyes that were diagnosed as grade Ⅰ,55 eyes that were diagnosed as grade Ⅱ,31 eyes that were diagnosed as grade Ⅲ,and 18 eyes that were diagnosed as grade Ⅳ according to Zhang＇s system.Conclusion Diagnoses of conjunctivochalasis using Zhang＇s system are more consistent with patient requests and the medical treatment strategies used than diagnoses made using Meller＇s system.
文摘Background The crescent excision of the inferior bulbar conjunctiva has been advised as a surgical procedure in the management of conjunctivochalasis refractory to medical treatments. However, it is difficult for this procedure to design how much conjunctival tissue should be excised. This study aimed to present a quantitative Iocator for conjunctiva resection and evaluate its effect on the treatment of conjunctivochalasis （CCh）. Methods Poly β-hydroxyethyl methacrylate resin/β-hydroxyethyl methacrylate （HEMA, water gel） was used as the material to make the quantitative Iocator which was designed to suit the specific patient. Forty-six patients with bilateral symptomatic CCh were included in this prospective study. Of the patients, while the right eye underwent the popularly used crescent-shaped conjunctiva resection （group I）, the left eye was treated with conjunctiva resection assisted by the quantitative Iocator （group II）. International Ocular Surface Disease Index （OSDI）, scores of remnant conjunctiva fold, complications and conjunctival cut healing, height of tear meniscus, tear break-up time （BUT）, and time of surgery were evaluated. Tasting chloromycetin test （TCT） was used to evaluate how the lacrimal duct worked. Results OSDI in group II （8.82±2.36） was significantly lower than that in group I （14.67±2.21） （t=12.22, P 〈0.01）. The amount of conjunctiva fold remaining in group II was less than that in group I. Scores of remnant conjunctiva fold in group I were significantly higher than those in group II （t=31.85, P 〈0.01）. While evaluation scores of conjunctival cut healing in group I were lower than those in group II, scores of complication in group I were significantly higher than those in group II at 8 weeks after surgery （t=89.60, P 〈0.01）. There was no significant difference in eyes with normal BUT （X^2=0.031, P=0.985） between the two groups, as the case was in eyes with positive TCT （X^2=0.14, P=0.930） and in eyes with normal height of tear meniscus （X^2=0.48, P=0.780）. Mean surgery time in group II （（17.11±2.08） minutes） was significantly shorter than that in group I （（25.22±4.78） minutes） （t=13.84, P 〈0.01）. Conclusion A quantitative Iocator can be used as an effective, safe, and less time-consuming instrument to facilitate conjunctival excision for symptomatic CCh treatment.
