Background: The chronic stage in Grave’s orbitopathy is characterised by fibr otic changes within the orbital soft tissues, especially the extraocular muscles . Retraction of the eyelids is a common clinical feature ...Background: The chronic stage in Grave’s orbitopathy is characterised by fibr otic changes within the orbital soft tissues, especially the extraocular muscles . Retraction of the eyelids is a common clinical feature of this phenomenon. To solve this problem several techniques for lengthening the upper eyelid have been described with variable rates of success. In this report we describe our modifi ed Harvey’s technique for the correction of upper eyelid retraction which inclu des a complete recession of the Müller’s muscle/levator complex from the tarsa l plate without the interposition of a spacer. Finally only the skin and the sup erficial orbicularis muscle are sutured. We also report about our results with t his procedure. Methods: 8 patients (1 male, 7 female) with lid retraction in Gra ve’s ophthalmopathy were recorded who had undergone the modified lengthening te chnique by an external approach between 2001 and 2004. Four patients underwent a bilateral procedure and 1 patient showed a significant undercorrection, necessi tating reoperation. So a total of 13 procedures were included in this follow-up study. Beside the common ophthalmological examination, special interest was put in the difference of the two eyelid apertures in primary position pre-and post operatively. Results: Within a follow-up period of at least 3 months we recorde d an averaged lengthening of the upper eyelid of 3.1 mm. The difference of the t wo eyelid apertures in primary position improved from 2.2 mm preoperatively to 1 .0 mm postoperatively. Only 1 patient needed reoperation because of a significan t undercorrection. There were no late overcorrections observed. Conclusions: The modified Harvey’s technique to lengthen the upper eyelid is a safe and effecti ve method to reduce upper eyelid retraction in Grave’s disease. An eventually r equired orbital decompression orextraocular muscle surgery has to be done before the lid surgery.展开更多
目的:基于网络药理学和分子对接技术探究海藻、昆布治疗Graves病的作用机制。方法:借助中药系统药理学数据库与分析平台(TCMSP)获得中药海藻、昆布的活性成分、靶点,运用蛋白质数据库Uniprot将靶点的基因名称规范化。分别在GeneCards、O...目的:基于网络药理学和分子对接技术探究海藻、昆布治疗Graves病的作用机制。方法:借助中药系统药理学数据库与分析平台(TCMSP)获得中药海藻、昆布的活性成分、靶点,运用蛋白质数据库Uniprot将靶点的基因名称规范化。分别在GeneCards、OMIM、DrugBank等数据库上检索Graves疾病靶点,使用R语言绘制海藻、昆布与Graves病交集靶点的韦恩图,并通过Cytoscape 3.8.2软件绘制“海藻、昆布-Graves病”活性成分-靶点图以及蛋白质-蛋白质相互作用网络图。利用DAVID数据库对药物与疾病交集基因进行基因本体论(GO)功能分析、京都基因与基因组百科全书(KEGG)通路富集分析。在PubChem数据库中下载小分子配体结构,在PDB数据库中下载蛋白受体结构,运用Autodock vina进行分子对接。结果:筛选出海藻、昆布与Graves病相关的活性成分11个、蛋白123个。GO功能富集分析显示,有生物过程585个、细胞组分63个、分子功能125个。KEGG通路富集分析显示,有相关通路149个。分子对接展现了具有较好相互作用的核心成分与核心蛋白的对接效果,核心成分有槲皮素和花生四烯酸,核心蛋白有Jun原癌基因(Jun Proto-Oncogene,JUN)、丝裂原活化蛋白激酶(MitogenActivated Protein Kinase,MAPK)1、肿瘤蛋白p53(Tumor Protein p53,TP53)。海藻、昆布可能通过调节晚期糖基化终末产物-晚期糖基化终末产物受体(AGE-RAGE)、肿瘤坏死因子(Tumor Necrosis Factor,TNF)等信号通路发挥治疗Graves病的作用。结论:海藻、昆布有效成分可能是槲皮素、花生四烯酸,它们分别通过JUN、MAPK1、TP53靶点蛋白,以及TNF-α、AGERAGE通路治疗Graves病。展开更多
文摘Background: The chronic stage in Grave’s orbitopathy is characterised by fibr otic changes within the orbital soft tissues, especially the extraocular muscles . Retraction of the eyelids is a common clinical feature of this phenomenon. To solve this problem several techniques for lengthening the upper eyelid have been described with variable rates of success. In this report we describe our modifi ed Harvey’s technique for the correction of upper eyelid retraction which inclu des a complete recession of the Müller’s muscle/levator complex from the tarsa l plate without the interposition of a spacer. Finally only the skin and the sup erficial orbicularis muscle are sutured. We also report about our results with t his procedure. Methods: 8 patients (1 male, 7 female) with lid retraction in Gra ve’s ophthalmopathy were recorded who had undergone the modified lengthening te chnique by an external approach between 2001 and 2004. Four patients underwent a bilateral procedure and 1 patient showed a significant undercorrection, necessi tating reoperation. So a total of 13 procedures were included in this follow-up study. Beside the common ophthalmological examination, special interest was put in the difference of the two eyelid apertures in primary position pre-and post operatively. Results: Within a follow-up period of at least 3 months we recorde d an averaged lengthening of the upper eyelid of 3.1 mm. The difference of the t wo eyelid apertures in primary position improved from 2.2 mm preoperatively to 1 .0 mm postoperatively. Only 1 patient needed reoperation because of a significan t undercorrection. There were no late overcorrections observed. Conclusions: The modified Harvey’s technique to lengthen the upper eyelid is a safe and effecti ve method to reduce upper eyelid retraction in Grave’s disease. An eventually r equired orbital decompression orextraocular muscle surgery has to be done before the lid surgery.
文摘目的:基于网络药理学和分子对接技术探究海藻、昆布治疗Graves病的作用机制。方法:借助中药系统药理学数据库与分析平台(TCMSP)获得中药海藻、昆布的活性成分、靶点,运用蛋白质数据库Uniprot将靶点的基因名称规范化。分别在GeneCards、OMIM、DrugBank等数据库上检索Graves疾病靶点,使用R语言绘制海藻、昆布与Graves病交集靶点的韦恩图,并通过Cytoscape 3.8.2软件绘制“海藻、昆布-Graves病”活性成分-靶点图以及蛋白质-蛋白质相互作用网络图。利用DAVID数据库对药物与疾病交集基因进行基因本体论(GO)功能分析、京都基因与基因组百科全书(KEGG)通路富集分析。在PubChem数据库中下载小分子配体结构,在PDB数据库中下载蛋白受体结构,运用Autodock vina进行分子对接。结果:筛选出海藻、昆布与Graves病相关的活性成分11个、蛋白123个。GO功能富集分析显示,有生物过程585个、细胞组分63个、分子功能125个。KEGG通路富集分析显示,有相关通路149个。分子对接展现了具有较好相互作用的核心成分与核心蛋白的对接效果,核心成分有槲皮素和花生四烯酸,核心蛋白有Jun原癌基因(Jun Proto-Oncogene,JUN)、丝裂原活化蛋白激酶(MitogenActivated Protein Kinase,MAPK)1、肿瘤蛋白p53(Tumor Protein p53,TP53)。海藻、昆布可能通过调节晚期糖基化终末产物-晚期糖基化终末产物受体(AGE-RAGE)、肿瘤坏死因子(Tumor Necrosis Factor,TNF)等信号通路发挥治疗Graves病的作用。结论:海藻、昆布有效成分可能是槲皮素、花生四烯酸,它们分别通过JUN、MAPK1、TP53靶点蛋白,以及TNF-α、AGERAGE通路治疗Graves病。
