Immunosuppressed patients have increased susceptibility to various infections,including opportunistic infections.The risk of infective complications in these patients is significantly higher,which can lead to more sev...Immunosuppressed patients have increased susceptibility to various infections,including opportunistic infections.The risk of infective complications in these patients is significantly higher,which can lead to more severe infections,prolonged illness course,and an increased likelihood of poor outcome,including sepsis,organ failure,and even death.Blue rubber bleb nevus syndrome(BRBNS)is a rare syndrome characterized by venous malformations primarily found in the skin and gastrointestinal(GI)tract.展开更多
Glaucoma filtration surgery(GFS)stands as the most effective intervention for reducing intraocular pressure,a critical component in glaucoma management.Despite its pivotal role,the scarring of the filtration bleb rema...Glaucoma filtration surgery(GFS)stands as the most effective intervention for reducing intraocular pressure,a critical component in glaucoma management.Despite its pivotal role,the scarring of the filtration bleb remains the primary impediment to successful GFS outcomes.Perioperative utilization of antimitotics,while frontline in combating fibrosis and modulating the wound healing process,carries the risk of vision-threatening complications.Given the complexity of the wound healing cascade and the potential insufficiency of targeting a single molecule,there is an imperative to expand therapeutic modalities through combination therapies.This review offers a comprehensive elucidation of the fibrogenesis post-GFS,a synthesis unprecedented in the available literature,and aims to inform the broadening of therapeutic strategies for GFS.展开更多
Filtration surgery is the commonest operation performed for closed angle or open angle glaucoma when medical treatment or laser trabeculoplasty has failed to control the intraocular pressure. It is characterized by th...Filtration surgery is the commonest operation performed for closed angle or open angle glaucoma when medical treatment or laser trabeculoplasty has failed to control the intraocular pressure. It is characterized by the formation of an artificial drainage fistula between the anterior chamber and subconjunctival space. The successful operation is evidenced by the appearance of a subconjunctival filtration bleb which in turn depends on the patency of this pathway. Despite numerous modification, the procedu...展开更多
目的观察眼部按摩与运动康复干预对青光眼小梁切除术后患者眼压控制和视力恢复的影响。方法选取60例接受青光眼小梁切除术治疗的患者作为研究对象,其中术后接受运动康复干预的30例患者作为对照组,术后接受眼部按摩与运动康复联合干预的3...目的观察眼部按摩与运动康复干预对青光眼小梁切除术后患者眼压控制和视力恢复的影响。方法选取60例接受青光眼小梁切除术治疗的患者作为研究对象,其中术后接受运动康复干预的30例患者作为对照组,术后接受眼部按摩与运动康复联合干预的30例患者作为观察组。对比两组患者眼部疼痛程度、眼压、前房深度、视力水平、眼内血流情况(阻力指数、收缩期峰值血流速度、舒张末期血流速度)、功能性滤过泡形成率。结果干预后,观察组眼部疼痛评分(1.44±0.13)分、眼压(14.94±1.33)mm Hg(1 mm Hg=0.133 kPa)、前房深度(2.37±0.26)mm均低于对照组的(2.36±0.38)分、(18.72±1.79)mmHg、(3.27±0.36)mm,视力水平(0.77±0.13)高于对照组的(0.51±0.09)(P<0.05)。干预后,两组患者眼内血流阻力指数、收缩期峰值血流速度、舒张末期血流速度均显著改善,且观察组眼内血流阻力指数(0.57±0.02)低于对照组的(0.67±0.07),收缩期峰值血流速度(29.01±2.42)cm/s、舒张末期血流速度(13.91±0.76)cm/s均高于对照组的(25.27±1.44)、(10.13±0.64)cm/s(P<0.05)。干预后,观察组功能性滤过泡形成率80.00%高于对照组的53.33%(P<0.05)。结论青光眼小梁切除术后接受眼部按摩与运动康复干预,患者眼压可以得到有效控制,视力得到更好的恢复,眼内血流情况改善,术后功能性滤过泡形成率增加,临床应用价值显著。展开更多
Blue rubber bleb nevus syndrome(BRBNS)is a rare disease characterized by multiple venous malformations and hemangiomas in the skin and visceral organs.The lesions often involve the cutaneous and gastrointestinal syste...Blue rubber bleb nevus syndrome(BRBNS)is a rare disease characterized by multiple venous malformations and hemangiomas in the skin and visceral organs.The lesions often involve the cutaneous and gastrointestinal systems.Other organs can also be involved,such as the central nervous system,liver,and muscles.The most common symptoms are gastrointestinal bleeding and secondary iron deficiency anemia.The syndrome may also present with severe complications such as rupture,intestinal torsion,and intussusception,and can even cause death.Cutaneous malformations are usually asymptomatic and do not require treatment.The treatment of gastrointestinal lesions is determined by the extent of intestinal involvement and severity of the disease.Most patients respond to supportive therapy,such as iron supplementation and blood transfusion.For more significant hemorrhages or severe complications,surgical resection,endoscopic sclerosis,and laser photocoagulation have been proposed.Here we present a case of BRBNS in a 45-year-old woman involving 16sites including the scalp,eyelid,orbit,lip,tongue,face,back,upper and lower limbs,buttocks,root of neck,clavicle area,superior mediastinum,glottis,esophagus,colon,and anus,with secondary severe anemia.In addition,we summarize the epidemiology,clinical manifestations,diagnosis,differential diagnosis and therapies of this disease by analyzing all previously reported cases to enhance the awareness of this syndrome.展开更多
BACKGROUND The major reason for filtering bleb failure or scarring of the bleb site is due to excessive scarring after glaucoma filtration surgery in the clinic.Traditional Chinese medicine has preeminence in the prev...BACKGROUND The major reason for filtering bleb failure or scarring of the bleb site is due to excessive scarring after glaucoma filtration surgery in the clinic.Traditional Chinese medicine has preeminence in the prevention of fibrosis formation through the regulation of systemic circulation and improvement of the properties of the inflammatory cells in the blood.AIM To examine the clinical efficacy of using the Modified Cortex Mori Capsules(MCMC;Chinese name:Jiawei Sangbaipi Capsules)in the success rate of functional filtering blebs after glaucoma filtering surgery in clinical patients.METHODS Sixty resurgery glaucoma patients were randomly divided into two groups:30 patients in surgery with the placebo group and 30 patients in surgery with the MCMC group.Patients took either the placebo or the MCMC 2 wk before and after surgery.Postoperative morphology and function filtering bleb,visual acuity,intraocular pressure,postoperative complications,the success rate of filtration surgery and clinical efficacy were observed.RESULTS Fifty patients completed the study.The percentage of functional filtering blebs in the surgery plus MCMC group was 84%at 6 mo after surgery,which was higher than surgery plus placebo group(64%,P<0.05).The surgical success rate in the MCMC and placebo groups were 79%±8.3%and 57%±10.6%respectively(P<0.05).The visual acuity,intraocular pressure and the postoperative complications in the two groups had no significant differences.CONCLUSION Glaucoma filtering surgery while taking MCMC not only reduced excessive scar formation and increased the success rate of functional filtering blebs but also improved the success of glaucoma filtration operations.展开更多
A 57-year-old woman previously diagnosed with blue rubber bleb nevus syndrome(BRBNS) reported hematemesis. BRBNS is a rare vascular anomaly syndrome consisting of multifocal hemangiomas of the skin and gastrointestina...A 57-year-old woman previously diagnosed with blue rubber bleb nevus syndrome(BRBNS) reported hematemesis. BRBNS is a rare vascular anomaly syndrome consisting of multifocal hemangiomas of the skin and gastrointestinal(GI) tract but her GI tract had never been examined. An upper gastrointestinal endoscopy revealed a large bleeding esophageal hematoma positioned between the thoracic esophagus and the gastric cardia. An endoscopic injection of polidocanol was used to stop the hematoma from bleeding. The hematoma was incised using the injectionneedle to reduce the pressure within it. Finally, argon plasma coagulation(APC) was applied to the edge of the incision. The esophageal hematoma disappeared seven days later. Two months after the endoscopic the rapy, the eso phage alulcerhealed and the hemangioma did not relapse. This rare case of a large esophageal hematoma originating from a hemangioma with BRBNS was treated using a combination of endoscopic therapy with polidocanol injection, incision, and APC.展开更多
AIM: To study the role of connective tissue growth factor (CTGF) antibody in inhibiting bleb scarring after glaucoma filtration surgery (GFS) in rabbit model. METHODS: GFS was performed on both eyes in five rabbits. O...AIM: To study the role of connective tissue growth factor (CTGF) antibody in inhibiting bleb scarring after glaucoma filtration surgery (GFS) in rabbit model. METHODS: GFS was performed on both eyes in five rabbits. One eye of each rabbit was chosen randomly as antibody group and received subconjunctival injection of 0.1mL CTGF antibody (50mg/L) immediately after GFS applied and on the 5 th day after GFS. The other eye of each rabbit as control group was received subconjunctival injection of 0.1mL PBS at the same time as antibody group. On postoperative days 1, 3, 5, 7, 10, and 14, the appearance of filtrating blebs was observed under slit lamp, the area and the intraocular pressure (IOP) were measured with micrometer and applanation tonometer, respectively. RESULTS: On postoperative days 1, 3, 5, 7, 10, and 14, areas of filtrating blebs in antibody group were all larger comparing with the control group (P<0.05) and IOPs of antibody group were lower than the control group(P<0.05). CONCLUSION: Subconjunctival injection of CTGF antibody can maintain larger bleb area and lower IOP after GFS in rabbit.展开更多
·AIM: To describe the outcomes of bleb needling in primary glaucoma in an Asian tertiary eye centre over a2 y period. To compare the success rates between primary angle-closure glaucoma(PACG) and primary open ang...·AIM: To describe the outcomes of bleb needling in primary glaucoma in an Asian tertiary eye centre over a2 y period. To compare the success rates between primary angle-closure glaucoma(PACG) and primary open angle glaucoma(POAG). Lastly, to identify factors associated with success of bleb needling.·METHODS: This was a retrospective review of 227 patients who underwent bleb needling between June2009 and June 2011 in Singapore National Eye Centre.The 5-fluorouracil(5-FU) augmented bleb needling was performed either at the slit lamp or in the operating theatre. Repeat bleb needlings were performed as necessary. Complete success was defined as maintenance of intraocular pressure(IOP) ≥6 mm Hg and ≤21 mm Hg, in the absence of further surgery or use of antiglaucoma medication. Qualified success met the above criteria with or without use of antiglaucoma medications.· RESULTS: One hundred and seventy-five eyes completed the two-year follow up. Sixty-nine percent of participants had POAG and 31% had PACG. The mean interval between filtering surgery and bleb needling was299.9 ±616.4d for POAG and 167.1 ±272.2d for PACG.Mean needling attempts were 1.9±1.4 and 2±1.6 for POAG and PACG respectively. In general, there was a statistically significant reduction of IOP ranging from21.9% to 26.8% from month 1 through to month 24. The complete success rates at month 6 were 70.0% for POAG and 65.7% for PACG. At month 12, this decreased to62.2% for POAG and PACG and at month 24, 57.9% for POAG and 63.0% for PACG respectively. The qualified success rates at month 6 for POAG and PACG were23.8% and 29.9% respectively, 32.2% and 29.2% at month12, and 34.7% and 29.6% at month 24. The success ratesbetween POAG and PACG were not significantly different(P 】0.05 for complete and qualified success at months 6,12 and 24). An increased number of needlings and higher pre-needling IOP were associated with failure.·CONCLUSION: The 5-FU augmented bleb needling within one year of trabeculectomy in Asian eyes can provide clinically significant IOP lowering of more than20% for 2y. POAG and PACG had similar complete success rates(58% and 63% respectively). Factors associated with greater risk of procedure failure included increased number of needlings and higher pre-needling IOP. Asian eyes have a greater propensity for scarring but bleb needling, if performed in a timely manner can rescue bleb function.展开更多
Purpose: To investigate the efficacy of a soft bandage contact lens in the management of early bleb leak following trabeculectomy.Methods: Between October 2011 and April 2013, 11 patients with early bleb leak followin...Purpose: To investigate the efficacy of a soft bandage contact lens in the management of early bleb leak following trabeculectomy.Methods: Between October 2011 and April 2013, 11 patients with early bleb leak following fornix-based trabeculectomy were instructed to wear a soft bandage contact lens 14 mm in diameter continuously for 1-2 weeks. The daily visual acuity,intraocular pressure(IOP), anterior chamber situation, and healing condition were measured at 1, 3, and 7 d, after con tact lens removal,.and 3 months after trabeculectomy..The conditions of blebs,.sensation of wearing contact lens,.and adverse events were recorded.Results:.Bleb leaks were observed at 2-8 d after surgery,(4.09±1.10 d on average). The daily Log MAR visual acuity did not significantly differ before and after contact lens wear(P>0.05). The IOP was significantly raised after at 1, 3, and7 d after lens wear.(all P <0.05).The IOP at 3 months after lens wear did not significantly differ from that measured at lens removal(t=1.191, P=0.089). At 1 d after lens wear, 6cases had deeper anterior chambers..All patients presented with a significantly deepened anterior chamber at 3 d after lens wear,.and were restored to the preoperative conditions..The bleb leakage was successfully treated at 7 d after lens removal in 10 patients, while 1 patient had to wear the contact lens for another 7 d for full healing of the bleb leak. No ocular infection was noted throughout the management.Conclusion: A soft bandage contact lens of 14 mm diameter is a safe and efficacious therapy for an early bleb leak following fornix-based trabeculectomy.展开更多
In cryopreservation,the addition of cryoprotectant can change the intra-and extra-cellular osmotic pressure,affect the cell morphology,and induce blebs on the plasma membrane.In this study,the blebs of cells microenca...In cryopreservation,the addition of cryoprotectant can change the intra-and extra-cellular osmotic pressure,affect the cell morphology,and induce blebs on the plasma membrane.In this study,the blebs of cells microencapsulated in the alginate microsphere induced by osmotic shock were studied,and the effects of microencapsulation on bleb size and cell viability were determined.Firstly,a coaxial co-flow focusing device was applied to generate cell-laden microcapsules using alginate hydrogel in this paper.Then,cellular blebs induced by DMSO with various concentrations under microencapsulation were compared with that when non-encapsulated,and the dynamic process of cellular bleb was investigated.Finally,the qualitative relationship between bleb size and cell viability in the presence of DMSO was built,and thus the effects of microencapsulation on bleb size and viability were evaluated.The results show that the bleb size is smaller and the cell viability is higher,and cell microencapsulation can significantly inhibit the excessively large blebs generated on the cell membrane and reduce the osmotic damage to cells when loading cryoprotectant and then to improve cell viability during cryopreservation.This work can provide insights for optimizing cryoprotectant-loading protocols,offer a new avenue to study cell blebbing,and advance future research on cryopreservation of rare cells and biomaterials.展开更多
AIM： To study the role of ultrasound biomicroscopy（UBM） in the assessment of the bleb function after trabeculectomy with mitomycin C（MMC）. METHODS： This was a cross-sectional study including all cases had underg...AIM： To study the role of ultrasound biomicroscopy（UBM） in the assessment of the bleb function after trabeculectomy with mitomycin C（MMC）. METHODS： This was a cross-sectional study including all cases had undergone trabeculectomy with MMC 0.2 mg/mL for 3 min. Participants were recruited from the follow-up cases at Department of Ophthalmology, Tanta University in the period from August 2015 to August 2016. Full history taking and ophthalmological examination were performed. Intraocular pressure（IOP） was measured using Goldmann applanation tonometry and the history of prescribed postoperative antiglaucoma medications was recorded. Accordingly, the trabeculectomy blebs were divided clinically into successful blebs when the IOP post-operative was ≤18 mmHg without medications. Scanning examination of the filtering bleb using UBM examination was performed at the period from 2 to 36 mo after trabeculectomy（13.6±9.7 m o）. RESULTS： This study included 33 trabeculectomy filtering blebs of 25 patients（9 males and 16 females）. The mean age of patients was 53.2±14.2 y（range 25-71y）. We had 20 eyes with complete success, 9 eyes with qualified success, and 4 eyes with failure after trabeculectomy with MMC. The blebs were classified into successful blebs（IOP ≤18 mmHg without antiglaucoma medications）, others were classified into qualified successful and failed blebs. There was a significant correlation between certain UBM findings（intra-bleb reflectivity, draining sub-scleral tract, bleb height, and intrableb fluid cysts） and cases with different grades of clinical functional success（P〈0.01）.CONCLUSION： UBM is an objective tool in the functional assessment of the post-trabeculectomy filtering bleb through a significant correlation between certain UBM parameters and the different grades of clinical functional success.展开更多
BACKGROUND Blue rubber bleb nevus syndrome(BRBNS)is a rare vascular disease,difficult to diagnose and choose a treatment method,especially in young children.There are several limiting factors to the use of enteroscopy...BACKGROUND Blue rubber bleb nevus syndrome(BRBNS)is a rare vascular disease,difficult to diagnose and choose a treatment method,especially in young children.There are several limiting factors to the use of enteroscopy for diagnostics and treatment in pediatric patients,in general.The literature on BRBNS cases is limited and presents various therapeutic approaches.CASE SUMMARY We present here a case of BRBNS involving a 4-year-old female,whose intestinal venous lesions were successfully treated by endoscopic sclerotherapy and aethoxysklerol foam.Skin lesions,typical for BRBNS,appeared on the 8th d of the child’s life and their number increased over the next several months.The child also experienced episodes of critical decrease in hemoglobin level(by as much as 52 g/L)for several years,requiring iron supplementation and several blood transfusions.Video capsule endoscopy revealed numerous vascular formations in the small bowel.The combined findings of gastrointestinal venous formations and skin lesions prompted BRBNS diagnosis.Single-balloon enteroscopy was used to perform sclerotherapy,with aethoxysklerol foam.A positive effect was observed within 19 mo of follow-up.We continue to monitor the patient’s hemoglobin level,every 2 wk,and it has remained satisfactory(>120 g/L).CONCLUSION Endoscopic sclerotherapy can be effective in the clinical management of gastrointestinal manifestations of BRBNS in young children.展开更多
AIM:To evaluate the effectiveness of knock-down of heat shock protein 47(HSP47)on conjunctival bleb scarring in a rat model and its possible mechanism.METHODS:Male Sprague–Dawley rats were used for glaucoma filtratio...AIM:To evaluate the effectiveness of knock-down of heat shock protein 47(HSP47)on conjunctival bleb scarring in a rat model and its possible mechanism.METHODS:Male Sprague–Dawley rats were used for glaucoma filtration surgery(GFS)and were treated with either phosphate buffered solution,shControl,mitomycin C,or sh-HSP47 using a microsyringe immediately after GFS.The morphology of filtering blebs was observed postoperatively.The levels of HSP47 were analyzed at 2,5,8,and 11d after GFS via real‑time quantitative polymerase chain reaction(PCR)and Western blot.The silencing effect of HSP47,the expression of collagen I and III,and the potential signaling pathways of HSP47 during scarification were explored 11d post GFS.The protein levels of transforming growth factor-β1(TGF-β1),phospho-Smad2(pSmad2),phospho-Smad3(p-Smad3),and phospho-p38(p-p38)were also analyzed using Western blot.RESULTS:Sh-HSP47 treatment significantly prolonged the functional filtration bleb retention.The levels of HSP47 were increased significantly at 5,8,and 11d postoperatively compared to the control group(P<0.05,P<0.01,and P<0.001).The levels of HSP47 protein at day 11 postoperatively were significantly down-regulated after HSP47 silencing using sh-HSP47 adenovirus transfection(P<0.01).Expression levels of collagen I and III within the blebs were significantly reduced in the absence of HSP47(P<0.01).Moreover,the protein levels of TGF-β1,p-Smad2/3,and p-p38 were dramatically inhibited after treatment with sh-HSP47(P<0.01).CONCLUSION:The inhibitory effects of HSP47 knockdown on scarring after GFS have the potential to be an efficacious therapeutic option for the treatment of conjunctival bleb scarring.展开更多
基金funded by Tianjin Key Medical Discipline(Specialty)Construction Project(TJYXZDXK-007A).
文摘Immunosuppressed patients have increased susceptibility to various infections,including opportunistic infections.The risk of infective complications in these patients is significantly higher,which can lead to more severe infections,prolonged illness course,and an increased likelihood of poor outcome,including sepsis,organ failure,and even death.Blue rubber bleb nevus syndrome(BRBNS)is a rare syndrome characterized by venous malformations primarily found in the skin and gastrointestinal(GI)tract.
基金Supported by Hospital Level Project of the Eye Hospital of China Academy of Chinese Medical Sciences(No.GSP5-40)Internal Project of the Eye Hospital of China Academy of Chinese Medical Sciences(No.1011632).
文摘Glaucoma filtration surgery(GFS)stands as the most effective intervention for reducing intraocular pressure,a critical component in glaucoma management.Despite its pivotal role,the scarring of the filtration bleb remains the primary impediment to successful GFS outcomes.Perioperative utilization of antimitotics,while frontline in combating fibrosis and modulating the wound healing process,carries the risk of vision-threatening complications.Given the complexity of the wound healing cascade and the potential insufficiency of targeting a single molecule,there is an imperative to expand therapeutic modalities through combination therapies.This review offers a comprehensive elucidation of the fibrogenesis post-GFS,a synthesis unprecedented in the available literature,and aims to inform the broadening of therapeutic strategies for GFS.
文摘Filtration surgery is the commonest operation performed for closed angle or open angle glaucoma when medical treatment or laser trabeculoplasty has failed to control the intraocular pressure. It is characterized by the formation of an artificial drainage fistula between the anterior chamber and subconjunctival space. The successful operation is evidenced by the appearance of a subconjunctival filtration bleb which in turn depends on the patency of this pathway. Despite numerous modification, the procedu...
文摘目的观察眼部按摩与运动康复干预对青光眼小梁切除术后患者眼压控制和视力恢复的影响。方法选取60例接受青光眼小梁切除术治疗的患者作为研究对象,其中术后接受运动康复干预的30例患者作为对照组,术后接受眼部按摩与运动康复联合干预的30例患者作为观察组。对比两组患者眼部疼痛程度、眼压、前房深度、视力水平、眼内血流情况(阻力指数、收缩期峰值血流速度、舒张末期血流速度)、功能性滤过泡形成率。结果干预后,观察组眼部疼痛评分(1.44±0.13)分、眼压(14.94±1.33)mm Hg(1 mm Hg=0.133 kPa)、前房深度(2.37±0.26)mm均低于对照组的(2.36±0.38)分、(18.72±1.79)mmHg、(3.27±0.36)mm,视力水平(0.77±0.13)高于对照组的(0.51±0.09)(P<0.05)。干预后,两组患者眼内血流阻力指数、收缩期峰值血流速度、舒张末期血流速度均显著改善,且观察组眼内血流阻力指数(0.57±0.02)低于对照组的(0.67±0.07),收缩期峰值血流速度(29.01±2.42)cm/s、舒张末期血流速度(13.91±0.76)cm/s均高于对照组的(25.27±1.44)、(10.13±0.64)cm/s(P<0.05)。干预后,观察组功能性滤过泡形成率80.00%高于对照组的53.33%(P<0.05)。结论青光眼小梁切除术后接受眼部按摩与运动康复干预,患者眼压可以得到有效控制,视力得到更好的恢复,眼内血流情况改善,术后功能性滤过泡形成率增加,临床应用价值显著。
文摘Blue rubber bleb nevus syndrome(BRBNS)is a rare disease characterized by multiple venous malformations and hemangiomas in the skin and visceral organs.The lesions often involve the cutaneous and gastrointestinal systems.Other organs can also be involved,such as the central nervous system,liver,and muscles.The most common symptoms are gastrointestinal bleeding and secondary iron deficiency anemia.The syndrome may also present with severe complications such as rupture,intestinal torsion,and intussusception,and can even cause death.Cutaneous malformations are usually asymptomatic and do not require treatment.The treatment of gastrointestinal lesions is determined by the extent of intestinal involvement and severity of the disease.Most patients respond to supportive therapy,such as iron supplementation and blood transfusion.For more significant hemorrhages or severe complications,surgical resection,endoscopic sclerosis,and laser photocoagulation have been proposed.Here we present a case of BRBNS in a 45-year-old woman involving 16sites including the scalp,eyelid,orbit,lip,tongue,face,back,upper and lower limbs,buttocks,root of neck,clavicle area,superior mediastinum,glottis,esophagus,colon,and anus,with secondary severe anemia.In addition,we summarize the epidemiology,clinical manifestations,diagnosis,differential diagnosis and therapies of this disease by analyzing all previously reported cases to enhance the awareness of this syndrome.
文摘BACKGROUND The major reason for filtering bleb failure or scarring of the bleb site is due to excessive scarring after glaucoma filtration surgery in the clinic.Traditional Chinese medicine has preeminence in the prevention of fibrosis formation through the regulation of systemic circulation and improvement of the properties of the inflammatory cells in the blood.AIM To examine the clinical efficacy of using the Modified Cortex Mori Capsules(MCMC;Chinese name:Jiawei Sangbaipi Capsules)in the success rate of functional filtering blebs after glaucoma filtering surgery in clinical patients.METHODS Sixty resurgery glaucoma patients were randomly divided into two groups:30 patients in surgery with the placebo group and 30 patients in surgery with the MCMC group.Patients took either the placebo or the MCMC 2 wk before and after surgery.Postoperative morphology and function filtering bleb,visual acuity,intraocular pressure,postoperative complications,the success rate of filtration surgery and clinical efficacy were observed.RESULTS Fifty patients completed the study.The percentage of functional filtering blebs in the surgery plus MCMC group was 84%at 6 mo after surgery,which was higher than surgery plus placebo group(64%,P<0.05).The surgical success rate in the MCMC and placebo groups were 79%±8.3%and 57%±10.6%respectively(P<0.05).The visual acuity,intraocular pressure and the postoperative complications in the two groups had no significant differences.CONCLUSION Glaucoma filtering surgery while taking MCMC not only reduced excessive scar formation and increased the success rate of functional filtering blebs but also improved the success of glaucoma filtration operations.
文摘A 57-year-old woman previously diagnosed with blue rubber bleb nevus syndrome(BRBNS) reported hematemesis. BRBNS is a rare vascular anomaly syndrome consisting of multifocal hemangiomas of the skin and gastrointestinal(GI) tract but her GI tract had never been examined. An upper gastrointestinal endoscopy revealed a large bleeding esophageal hematoma positioned between the thoracic esophagus and the gastric cardia. An endoscopic injection of polidocanol was used to stop the hematoma from bleeding. The hematoma was incised using the injectionneedle to reduce the pressure within it. Finally, argon plasma coagulation(APC) was applied to the edge of the incision. The esophageal hematoma disappeared seven days later. Two months after the endoscopic the rapy, the eso phage alulcerhealed and the hemangioma did not relapse. This rare case of a large esophageal hematoma originating from a hemangioma with BRBNS was treated using a combination of endoscopic therapy with polidocanol injection, incision, and APC.
基金Natural Science Foundation of Shaanxi Province,China(No.2001SM66)
文摘AIM: To study the role of connective tissue growth factor (CTGF) antibody in inhibiting bleb scarring after glaucoma filtration surgery (GFS) in rabbit model. METHODS: GFS was performed on both eyes in five rabbits. One eye of each rabbit was chosen randomly as antibody group and received subconjunctival injection of 0.1mL CTGF antibody (50mg/L) immediately after GFS applied and on the 5 th day after GFS. The other eye of each rabbit as control group was received subconjunctival injection of 0.1mL PBS at the same time as antibody group. On postoperative days 1, 3, 5, 7, 10, and 14, the appearance of filtrating blebs was observed under slit lamp, the area and the intraocular pressure (IOP) were measured with micrometer and applanation tonometer, respectively. RESULTS: On postoperative days 1, 3, 5, 7, 10, and 14, areas of filtrating blebs in antibody group were all larger comparing with the control group (P<0.05) and IOPs of antibody group were lower than the control group(P<0.05). CONCLUSION: Subconjunctival injection of CTGF antibody can maintain larger bleb area and lower IOP after GFS in rabbit.
文摘·AIM: To describe the outcomes of bleb needling in primary glaucoma in an Asian tertiary eye centre over a2 y period. To compare the success rates between primary angle-closure glaucoma(PACG) and primary open angle glaucoma(POAG). Lastly, to identify factors associated with success of bleb needling.·METHODS: This was a retrospective review of 227 patients who underwent bleb needling between June2009 and June 2011 in Singapore National Eye Centre.The 5-fluorouracil(5-FU) augmented bleb needling was performed either at the slit lamp or in the operating theatre. Repeat bleb needlings were performed as necessary. Complete success was defined as maintenance of intraocular pressure(IOP) ≥6 mm Hg and ≤21 mm Hg, in the absence of further surgery or use of antiglaucoma medication. Qualified success met the above criteria with or without use of antiglaucoma medications.· RESULTS: One hundred and seventy-five eyes completed the two-year follow up. Sixty-nine percent of participants had POAG and 31% had PACG. The mean interval between filtering surgery and bleb needling was299.9 ±616.4d for POAG and 167.1 ±272.2d for PACG.Mean needling attempts were 1.9±1.4 and 2±1.6 for POAG and PACG respectively. In general, there was a statistically significant reduction of IOP ranging from21.9% to 26.8% from month 1 through to month 24. The complete success rates at month 6 were 70.0% for POAG and 65.7% for PACG. At month 12, this decreased to62.2% for POAG and PACG and at month 24, 57.9% for POAG and 63.0% for PACG respectively. The qualified success rates at month 6 for POAG and PACG were23.8% and 29.9% respectively, 32.2% and 29.2% at month12, and 34.7% and 29.6% at month 24. The success ratesbetween POAG and PACG were not significantly different(P 】0.05 for complete and qualified success at months 6,12 and 24). An increased number of needlings and higher pre-needling IOP were associated with failure.·CONCLUSION: The 5-FU augmented bleb needling within one year of trabeculectomy in Asian eyes can provide clinically significant IOP lowering of more than20% for 2y. POAG and PACG had similar complete success rates(58% and 63% respectively). Factors associated with greater risk of procedure failure included increased number of needlings and higher pre-needling IOP. Asian eyes have a greater propensity for scarring but bleb needling, if performed in a timely manner can rescue bleb function.
基金supported by Fund for Medical Sciences of Guangdong Province(Grant:B2012264)
文摘Purpose: To investigate the efficacy of a soft bandage contact lens in the management of early bleb leak following trabeculectomy.Methods: Between October 2011 and April 2013, 11 patients with early bleb leak following fornix-based trabeculectomy were instructed to wear a soft bandage contact lens 14 mm in diameter continuously for 1-2 weeks. The daily visual acuity,intraocular pressure(IOP), anterior chamber situation, and healing condition were measured at 1, 3, and 7 d, after con tact lens removal,.and 3 months after trabeculectomy..The conditions of blebs,.sensation of wearing contact lens,.and adverse events were recorded.Results:.Bleb leaks were observed at 2-8 d after surgery,(4.09±1.10 d on average). The daily Log MAR visual acuity did not significantly differ before and after contact lens wear(P>0.05). The IOP was significantly raised after at 1, 3, and7 d after lens wear.(all P <0.05).The IOP at 3 months after lens wear did not significantly differ from that measured at lens removal(t=1.191, P=0.089). At 1 d after lens wear, 6cases had deeper anterior chambers..All patients presented with a significantly deepened anterior chamber at 3 d after lens wear,.and were restored to the preoperative conditions..The bleb leakage was successfully treated at 7 d after lens removal in 10 patients, while 1 patient had to wear the contact lens for another 7 d for full healing of the bleb leak. No ocular infection was noted throughout the management.Conclusion: A soft bandage contact lens of 14 mm diameter is a safe and efficacious therapy for an early bleb leak following fornix-based trabeculectomy.
基金partially supported by the National Natural Science Foundation of China (81571768)
文摘In cryopreservation,the addition of cryoprotectant can change the intra-and extra-cellular osmotic pressure,affect the cell morphology,and induce blebs on the plasma membrane.In this study,the blebs of cells microencapsulated in the alginate microsphere induced by osmotic shock were studied,and the effects of microencapsulation on bleb size and cell viability were determined.Firstly,a coaxial co-flow focusing device was applied to generate cell-laden microcapsules using alginate hydrogel in this paper.Then,cellular blebs induced by DMSO with various concentrations under microencapsulation were compared with that when non-encapsulated,and the dynamic process of cellular bleb was investigated.Finally,the qualitative relationship between bleb size and cell viability in the presence of DMSO was built,and thus the effects of microencapsulation on bleb size and viability were evaluated.The results show that the bleb size is smaller and the cell viability is higher,and cell microencapsulation can significantly inhibit the excessively large blebs generated on the cell membrane and reduce the osmotic damage to cells when loading cryoprotectant and then to improve cell viability during cryopreservation.This work can provide insights for optimizing cryoprotectant-loading protocols,offer a new avenue to study cell blebbing,and advance future research on cryopreservation of rare cells and biomaterials.
文摘AIM： To study the role of ultrasound biomicroscopy（UBM） in the assessment of the bleb function after trabeculectomy with mitomycin C（MMC）. METHODS： This was a cross-sectional study including all cases had undergone trabeculectomy with MMC 0.2 mg/mL for 3 min. Participants were recruited from the follow-up cases at Department of Ophthalmology, Tanta University in the period from August 2015 to August 2016. Full history taking and ophthalmological examination were performed. Intraocular pressure（IOP） was measured using Goldmann applanation tonometry and the history of prescribed postoperative antiglaucoma medications was recorded. Accordingly, the trabeculectomy blebs were divided clinically into successful blebs when the IOP post-operative was ≤18 mmHg without medications. Scanning examination of the filtering bleb using UBM examination was performed at the period from 2 to 36 mo after trabeculectomy（13.6±9.7 m o）. RESULTS： This study included 33 trabeculectomy filtering blebs of 25 patients（9 males and 16 females）. The mean age of patients was 53.2±14.2 y（range 25-71y）. We had 20 eyes with complete success, 9 eyes with qualified success, and 4 eyes with failure after trabeculectomy with MMC. The blebs were classified into successful blebs（IOP ≤18 mmHg without antiglaucoma medications）, others were classified into qualified successful and failed blebs. There was a significant correlation between certain UBM findings（intra-bleb reflectivity, draining sub-scleral tract, bleb height, and intrableb fluid cysts） and cases with different grades of clinical functional success（P〈0.01）.CONCLUSION： UBM is an objective tool in the functional assessment of the post-trabeculectomy filtering bleb through a significant correlation between certain UBM parameters and the different grades of clinical functional success.
文摘BACKGROUND Blue rubber bleb nevus syndrome(BRBNS)is a rare vascular disease,difficult to diagnose and choose a treatment method,especially in young children.There are several limiting factors to the use of enteroscopy for diagnostics and treatment in pediatric patients,in general.The literature on BRBNS cases is limited and presents various therapeutic approaches.CASE SUMMARY We present here a case of BRBNS involving a 4-year-old female,whose intestinal venous lesions were successfully treated by endoscopic sclerotherapy and aethoxysklerol foam.Skin lesions,typical for BRBNS,appeared on the 8th d of the child’s life and their number increased over the next several months.The child also experienced episodes of critical decrease in hemoglobin level(by as much as 52 g/L)for several years,requiring iron supplementation and several blood transfusions.Video capsule endoscopy revealed numerous vascular formations in the small bowel.The combined findings of gastrointestinal venous formations and skin lesions prompted BRBNS diagnosis.Single-balloon enteroscopy was used to perform sclerotherapy,with aethoxysklerol foam.A positive effect was observed within 19 mo of follow-up.We continue to monitor the patient’s hemoglobin level,every 2 wk,and it has remained satisfactory(>120 g/L).CONCLUSION Endoscopic sclerotherapy can be effective in the clinical management of gastrointestinal manifestations of BRBNS in young children.
基金Supported by the National Natural Science Foundation of China(No.81500719)Shaanxi Science and Technology Project(No.2022SF-434)Xi’an Science and Technology Project(No.21YXYJ0044).
文摘AIM:To evaluate the effectiveness of knock-down of heat shock protein 47(HSP47)on conjunctival bleb scarring in a rat model and its possible mechanism.METHODS:Male Sprague–Dawley rats were used for glaucoma filtration surgery(GFS)and were treated with either phosphate buffered solution,shControl,mitomycin C,or sh-HSP47 using a microsyringe immediately after GFS.The morphology of filtering blebs was observed postoperatively.The levels of HSP47 were analyzed at 2,5,8,and 11d after GFS via real‑time quantitative polymerase chain reaction(PCR)and Western blot.The silencing effect of HSP47,the expression of collagen I and III,and the potential signaling pathways of HSP47 during scarification were explored 11d post GFS.The protein levels of transforming growth factor-β1(TGF-β1),phospho-Smad2(pSmad2),phospho-Smad3(p-Smad3),and phospho-p38(p-p38)were also analyzed using Western blot.RESULTS:Sh-HSP47 treatment significantly prolonged the functional filtration bleb retention.The levels of HSP47 were increased significantly at 5,8,and 11d postoperatively compared to the control group(P<0.05,P<0.01,and P<0.001).The levels of HSP47 protein at day 11 postoperatively were significantly down-regulated after HSP47 silencing using sh-HSP47 adenovirus transfection(P<0.01).Expression levels of collagen I and III within the blebs were significantly reduced in the absence of HSP47(P<0.01).Moreover,the protein levels of TGF-β1,p-Smad2/3,and p-p38 were dramatically inhibited after treatment with sh-HSP47(P<0.01).CONCLUSION:The inhibitory effects of HSP47 knockdown on scarring after GFS have the potential to be an efficacious therapeutic option for the treatment of conjunctival bleb scarring.
