电镜观察聚四氟乙烯异质移植膜对结膜再生的实验研究

在实验性兔眼前段重症碱烧伤早期使用聚四氟乙烯（ＰＴＦＥ）异质移植膜，代替自体粘膜移植，观察该材料对结膜创面的保护作用及其对残存结膜组织再生修复的引导作用。通过扫描电镜（ＳＥＭ）、裂隙灯检查及病理组织学等方法，对６４例眼进行分组对比研究。结果显示ＰＴＦＥ异质植片对组织刺激性小，能显著减少睑球粘连发生率。在碱烧伤后三周末，实验组与对照组睑球粘连发生率分别为３７．５％与７１．９％（Ｐ＜０．０１）。四周时电镜扫描ＰＴＦＥ植片表面未见细胞内生及覆盖，结膜修复后表现细胞轮廓清晰，走向规整。病理学检查显示实验组结膜组织仅有轻度的异物反应及慢性炎症反应。认为ＰＴＦＥ异质膜用于眼前段重建手术，是理想的结膜再生引导物及粘膜移植的合理替代。

Effect of ageing on colonic mucosal regeneration

The physiologic and pathologic cellular and molecular changes occurring with age in the human colon affect both the inflammatory process leading to mucosal injury and the regenerative capacity of the epithelium.On the one hand,age-related telomere shortening and inflamm-ageing may lead to the development of colonic inflammation,which results in epithelial damage.On the other hand,the altered migration and function of regenerative stem cells,the age-related methylation of mucosal healing-associated genes,together with the alterations of growth factor signaling with age,may be involved in delayed mucosal regeneration.The connections of these alterations to the process of ageing are not fully known.The understanding and customtailored modification of these mechanisms are of great clinical importance with regard to disease prevention and modern therapeutic strategies.Here,we aim to summarize the age-related microscopic and molecular changes of the human colon,as well as their role in altered mucosal healing.

翼状胬肉切除联合上方球结膜瓣游离移植术后结膜瓣修复方式的研究

观察翼状胬肉切除联合球结膜游离移植术患者的供体区和移植区结膜瓣的愈合过程,为临床手术治疗提供依据。方法 将昆明医科大学第一附属医院眼科2017年1月至2018年1月以来门诊收治的45例符合标准的初诊翼状胬肉患者纳入研究,对标准化的翼状胬肉切除联合球结膜游离移植术后的患者,用眼前节照相观察患者恢复情况、眼前节OCT活体生物测量供体区结膜的厚度数据和形态学。结果 在翼状胬肉体下方和移植术后的各组中,皆可见明显的球结膜下间隙,其术后一周明显增宽。术1天和术后1周供体区结膜明显变薄(p<0.01),术后2周明显变厚(p<0.05),1月后结膜厚度恢复正常,结膜下未见明显瘢痕组织形成。结论 翼状胬肉切除联合球结膜游离移植术供体区和移植区的结膜下皆不会形成瘢痕组织,不会增加患者潜在实施内眼手术的难度,移植结膜瓣组织解剖结构相对保留完整,不会形成结膜下瘢痕黏连。