ObjectiveTo observe and analyze the clinical features and prognosis of endogenous klebsiella pneumoniae endophthalmitis (EKPE).MethodsThis is a retrospective case series study. Seven patients (8 eyes) with EKPE were enrolled in this study. There were 3 males (4 eyes) and 4 females (4 eyes). The ages were from 39 to 76 years, the mean age was 57.29 years. All these cases had no history of trauma and surgery. Meanwhile, they all had some risk factors, such as infection, diabetes mellitus, systemic lupus erythematosus, liver abscess, renal insufficiency undergoing dialysis treatment, Hodgkin lymphoma and so on. All the eyes were undertaken visual acuity, slit lamp and fundus examination to observe the eye conditions. Seven eyes were undertaken pars plana vitrectomy with intravitreal injection of antibiotics from 2 days to 2 weeks after onset. And only one eye was undertaken intravitreal injection of antibiotics without surgery. Microbial stains and culture were performed for 7 eyes using vitreous and aqueous fluid samples from the procedures of vitrectomy. Meanwhile, culture and drug sensitive tests were performed from blood samples. According to the result of the drug sensitive tests, carbapenems such as imipenem and meropenem were used in each patient through intravenous injection from 1 to 2 weeks. During the follow up period from 3 days to 1 year, prognosis was observed at each office visit.ResultsFrom these eight eyes, presenting visual acuity was light perception (4 eyes), hand motion (3 eyes), 0.1 (1 eye). Hypopyon (6 eyes), aqueous fluid opacity (2 eyes) and diffuse vitreous opacity (8 eyes) were found. Changes in fundus like optic disc, macular edema and retinal vascular occlusion could be observed. Cultures of the vitreous and aqueous fluid samples from vitrectomy were all point out to klebsiella pneumoniae. At last office visit, the visual acuity of patients with hypopyon was no light perception (1 eye), light perception (1 eye), hand motion (1 eye). The visual acuity of patients without hypopyon was 0.05 (1 eye) and 0.5(1 eye). Finally, 1 eye was underwent enucleation and one patient with binocular disease was died of multiple organ failure.ConclusionsEKPE is almost unilateral attacked. Changes in fundus like optic disc, macular edema and retinal vascular occlusion can be observed. EKPE is commonly associated with poor visual outcomes. It is useful to save patients’ visual acuity by performing vitrectomy before hypopyon happened.
ObjectiveTo explore the effect of transplanting neonatal porcine islet cells of pig via hepatic portal vein in type Ⅰ diabetic monkeys.MethodIn this study, three pig-monkey islet xenotransplantation experiments were carried out by using α-1, 3-galactosyltransferase (GGTA1) gene knockout neonatal pig islet cells.ResultsThree macaques were successfully transplanted with islet cells. After the operation, their vital signs were stable and no symptoms of venous embolism occurred. After transplantation, the blood glucose and the dosage of exogenous insulin were significantly reduced, and the specific porcine C-peptide could be detected. Three macaques developed symptoms of ketoacidosis, and one macaque developed wound infection. After symptomatic treatment, all of them survived for 16 weeks.ConclusionGGTA1 knockout neonatal porcine islet cells transplanted through hepatic portal vein is effective for the treatment of type Ⅰ diabetes.
Objective To evaluate the effect of the plasma treated PLGA nerve conduits seeded BMSCs on repairing SD rat sciatic nerve defects. Methods BMSCs were acquired from 30 newborn SD rats. After ampl ified and passaged for 3 times, PLGA nerve conduits were prepared and some of them were treated with plasma. A 1-cm-length sciatic nerve defect wasmade in 30 4-week-old SD rats, then they were randomly divided into 3 groups for three different nerve defects reconstruction methods (n=10). In the experimental group, defect was repaired by plasma treatment and PGLA nerve conduits seeded with BMSCs; in the control group, by normal PLGA nerve conduits seeded with BMSCs; and in the autologous group, by autologous nerve. At 6 weeks after the surgery, the dynamic walking pattern was recorded and the sciatic function index (SFI) was calculated; the electrophysiological test was taken; the gastrocnemius wet weight recovery rate was calculated; and the image analysis of regenerated nerve was made. Results All rats survived after the surgery and l ived to the end of the experiment. At 6 weeks after the surgery, the dynamic walking pattern of the experimental group and autologous group was better than that of the control group. The SFI value of the experimental, control and autologous groups was —51.02 ± 6.54, —58.73 ± 7.87 and —48.73 ± 3.95, respectively, showing statistically significant differences among the experimental group, control group and autologous group (P lt; 0.05). The results of the motor nerve conduction velocity and wave ampl itude showed that there were statistically significant differences between the experimental group and the control group (P lt; 0.05), and between the control group and the autologous group (Plt; 0.01); but no significant difference between the experimental group and autologous group(Pgt; 0.05); The gastrocnemius wet weight recovery rate of the experimental, control and autologous groups was 56.13% ± 4.27%, 43.14% ± 6.52%, 59.47% ± 3.85%, respectively; showing statistically significant differences among experimental group, control group and autologous group (P lt; 0.05). The density, diameter of regenerated nerve fiber as well as neural sheath thickness of the experimental group were all higher than those of the control group (P lt; 0.05) and lower than those of the autologous nerve group (P lt; 0.05); there was significant difference between the control group and the autologous group (P lt; 0.01). Conclusion Plasma treated PLGA nerve conduits seeded with BMSCs can effectively repair sciatic nerve defects and provide a new strategy for the development of tissue engineered nerve to repair the peripheral nerve defects.
Objectives To observe the changes of axonal transport in the rabbit optic nerve under acute ocular hypertensions. Methods 24 adult healthy New Zealand white rabbits were divided into 4 groups according to the intraocular pressure (IOP), with 6 rabbits in each group. There are 3 experimental groups with an IOP of 20, 30, 40 mm Hg (1 mm Hg=0.133 kPa). respectively, and 1 control group with an IOP of 10 -15 mm Hg.Two 25-gauge cannulas were inserted into each rabbitprime;s anterior chamber to create the model of acute ocular hypertension. At the beginning of the experiment, rhodamine-beta;-isothiocyanate (RITC) was injected into the vitreous of each eye to label axonal transport. After 3 hours of high intraocular pressure, rabbits were sacrificed with anesthetic overdose. The retina and the optic nerve were then carefully exposed. Fluorescent microscopy was used for quantitative measurements of the changes of optic nerve axonal transport. Statistically analyze the average grey level in different groups and sites by Leica RITC Q500IW image analysis software. Results RITC, a fluorescent tracer, was transported in the anterograde direction by axonal transport. With the increasing of the intraocular pressure, the distance of the axonal transport was declined (F=159.3, P＜0.05). The difference of the grey level in the pre-laminar region of 20, 30, 40 mm Hg group was not statistically significant (F=0.2545,P＞0.05 ). Compared the grey level of 40 mm Hg group with control group, the differences in lamina cribrosa（t=5.684）and the proximal 350 mu;m of the post-laminar (t=5.124) were statistically significant (P＜0.05). Compared the grey level of 20, 30 mm Hg group with control group, the difference was not statistically significant(t=1.747, P＞0.05 ).Conclusion 40 mmHg intraocular pressure lasts for 3 hours can reduce axonal transport in the lamina cribrosa and post laminar of optic nerve.