Inhibitory effect of polysulfated heparin endostatin on alkali burn induced corneal neovascularization in rabbits

AIM: To investigate anti-angiogenic effects of polysulfated heparin endostatin(PSH-ES) on alkali burn induced corneal neovascularization(NV) in rabbits.METHODS: An alkali burn was made on rabbit corneas to induce corneal NV in the right eye of 24 rabbits. One day after burn creation, a 0.2 m L subconjunctival injection of 50 μg/m L PSH-ES, 50 μg/m L recombinant endostatin(ES), or normal saline was administered every other day for a total of 14d(7 injections). Histology and immunohistochemisty were used to examine corneas.Corneal NV growth was evaluated as microvessel quantity and corneal vascular endothelial growth factor(VEGF)expression was measured by immunohistochemical assay.RESULTS: Subconjunctival injection of ES and PSHES resulted in significant corneal NV suppression, but PSH-ES had a more powerful anti-angiogenic effect than ES. Mean VEGF concentration in PSH-ES treated corneas was significantly lower than in ES treated and saline treated corneas. Histological examination showed that corneas treated with either PSH-ES or ES had significantly fewer microvessels than eyes treated with saline. Additionally corneas treated with PSH-ES had significantly fewer microvessels than corneas treated with ES.CONCLUSION: Both PSH-ES and recombinant ES effectively inhibit corneal NV induced by alkali burn.However, PSH-ES is a more powerful anti-angiogenic agent than ES. This research has the potential to provide a new treatment option for preventing and treating corneal NV.

Comprehensive treatment of deep frostbite of multiple fingers after trauma:A case report

BACKGROUND Frostbite is becoming increasingly common in urban environments,and severe cases can lead to tissue loss.The treatment goal is to preserve tissue and function;the sooner appropriate treatment is administered,the more tissue can be saved.However,not every patient with deep frostbite seeks medical care promptly.CASE SUMMARY We report the case of a 73-year-old male patient who was lost in the wilderness for 2 d due to trauma and confusion.He experienced deep frostbite on multiple fingers.Treatment should not be discontinued for patients with deep frostbite who present after the optimum treatment timing.Bullae that no longer form(bloody)blisters within 24 h of aspiration should be removed.Mucopolysaccharide polysulfate cream has clinical value in frostbite treatment.The patient was transferred to Chinese Academy of Medical Sciences and Peking Union Medical College Hospital 12 h after being rescued.The patient had contraindications for thrombolysis,the most effective treatment,due to intracranial hemorrhage and presenting past the optimum treatment timing.We devised a comprehensive treatment plan,which involved delayed use vasodilators and high-pressure oxygen therapy at day 49 post-injury.We experimented with mucopolysaccharide polysulfate cream to treat the frostbite.The aim of the treatment was to safeguard as much tissue as possible.In the end,the fingers that suffered from frostbite were able to be partially preserved.CONCLUSION The case indicated that patients with severe frostbite who missed the optimal treatment time and had contraindications for thrombolysis could still partially preserve the affected limbs through comprehensive treatment.