Endoplasmic Reticulum Stress-induced Endothelial Dysfunction Promotes Neointima Formation after Arteriovenous Grafts in Mice on High-fat Diet

Objective Endothelial dysfunction is one candidate for triggering neointima formation after arteriovenous grafts(AVGs),but the factors mediating this process are unclear.The purpose of this study was to investigate the role of endoplasmic reticulum stress(ERS)-induced endothelial dysfunction in neointima formation following AVGs in high-fat diet(HFD)mice.Methods CCAAT-enhancer-binding protein-homologous protein(CHOP)knockout(KO)mice were created.Mice were fed with HFD to produce HFD model.AVGs model were applied in the groups of WT ND,WT HFD,and CHOP KO HFD.Human umbilical vein endothelial cells(HUVECs)were cultured with oxidized low density lipoprotein(ox-LDL)(40 mg/L)for the indicated time lengths(0,6,12,24 h).ERS inhibitor tauroursodeoxycholic acid(TUDCA)was used to block ERS.Immunohistochemical staining was used to observe the changes of ICAM1.Changes of ERS were detected by real-time RT-PCR.Protein expression levels and ERS activation were detected by Western blotting.Endothellial cell function was determined by endothelial permeability assay and transendothelial migration assay.Results HFD increased neointima formation in AVGs associated with endothelial dysfunction.At the same time,ERS was increased in endothelial cells(ECs)after AVGs in mice consuming the HFD.In vitro,ox-LDL was found to stimulate ERS,increase the permeability of the EC monolayer,and cause endothelial dysfunction.Blocking ERS with TUDCA or CHOP siRNA reversed the EC dysfunction caused by ox-LDL.In vivo,knockout of CHOP(CHOP KO)protected the function of ECs and decreased neointima formation after AVGs in HFD mice.Conclusion Inhibiting ERS in ECs could improve the function of AVGs.

3D printed grafts with gradient structures for organized vascular regeneration

Synthetic vascular grafts suitable for small-diameter arteries(<6 mm) are in great need.However,there are still no commercially available small-diameter vascular grafts(SDVGs) in clinical practice due to thrombosis and stenosis after in vivo implantation.When designing SDVGs,many studies emphasized reendothelization but ignored the importance of reconstruction of the smooth muscle layer(SML).To facilitate rapid SML regeneration,a high-resolution 3D printing method was used to create a novel bilayer SDVG with structures and mechanical properties mimicking natural arteries.Bioinspired by the collagen alignment of SML,the inner layer of the grafts had larger pore sizes and high porosity to accelerate the infiltration of cells and their circumferential alignment,which could facilitate SML reconstruction for compliance restoration and spontaneous endothelialization.The outer layer was designed to induce fibroblast recruitment by low porosity and minor pore size and provide SDVG with sufficient mechanical strength.One month after implantation,the arteries regenerated by 3D-printed grafts exhibited better pulsatility than electrospun grafts,with a compliance(8.9%) approaching that of natural arteries(11.36%) and significantly higher than that of electrospun ones(1.9%).The 3D-printed vascular demonstrated a three-layer structure more closely resembling natural arteries while electrospun grafts showed incomplete endothelium and immature SML.Our study shows the importance of SML reconstruction during vascular graft regeneration and provides an effective strategy to reconstruct blood vessels through 3D-printed structures rapidly.

Bilayer nicorandil-loaded small-diameter vascular grafts improve endothelial cell function via PI3K/AKT/eNOS pathway

For the surgical treatment of cardiovascular disease(CVD),there is a clear and unmet need in developing small-diameter(diameter<6 mm)vascular grafts.In our previous work,sulfated silk fibroin(SF)was successfully fabricated as a potential candidate for preparing vascular grafts due to the great cytocompatibility and hemocompatibility.However,vascular graft with single layer is difficult to adapt to the complex internal environment.In this work,polycaprolactone(PCL)and sulfated SF were used to fabricate bilayer vascular graft(BLVG)to mimic the structure of natural blood vessels.To enhance the biological activity of BLVG,nicorandil(NIC),an FDA-approved drug with multi-bioactivity,was loaded in the BLVG to fabricate NIC-loaded BLVG.The morphology,chemical composition and mechanical properties of NIC-loaded BLVG were assessed.The results showed that the bilayer structure of NIC-loaded BLVG endowed the graft with a biphasic drug release behavior.The in vitro studies indicated that NIC-loaded BLVG could significantly increase the proliferation,migration and antioxidation capability of endothelial cells(ECs).Moreover,we found that the potential biological mechanism was the activation of PI3K/AKT/eNOS signaling pathway.Overall,the results effectively demonstrated that NIC-loaded BLVG had a promising in vitro performance as a functional small-diameter vascular graft.

SHEAR STRESS RESISTANCE OF ENDOTHELIAL CELLS LINED ON PRETREATED PTFE VASCULAR GRAFTS

he potential benefits of endothelial cell seeding depend not only on effective cell attachment, but also on the ability of the cells to resist the shear stresses of blood flow. The shear stressresistance of cultured adult human endothelial cells was investigated on 6mm polytetrafluoroethylene vascular grafts (made in China). Endothelial cells were sodded onto pretreated vascular grafts at a high density. Grafts were then cultivated for 9 days to enable the maturation of thecytoskeleton, before they were exposed to pulsatile flow simulating the flow patterns and the wallshear forces of the small srtery. After 1 hour of per fusion,a cell loss of 11% in grafts pretreatedwith 20μ g/ ml fibronectin and of 12% in grafts pretreated with 5μ g /ml fibronectin coated human platelet- poor- plasma (p>0. 50 n = 10). Therefore we conclude that the endothelial celllining on vascular grafts pretreated with suitable substrates can form a shear stress-resistant endothelial cell monolayer on polytetrafluoroethylene vascular grafts.

Visual acuity and endothelial cell density with respect to the graft thickness in Descemet's stripping automated endothelial keratoplasty: one year results

AIM: To evaluate the visual acuity and endothelial cell density according to the thickness in Descemet’s stripping automated endothelial keratoplasty(DSAEK)one year after surgery.METHODS: DSAEK patients’ data were reviewed. Thirty seven eyes of 37 patients who underwent DSAEK for pseudophakic bullous keratopathy(PBK) were included in this study. Graft thickness was measured with optical coherence tomography(OCT) 12 mo after DSAEK. Eyes were divided into 3 groups based on the graft thickness:thick(】200 μm), medium-thick(150-200 μm) and thin(【150 μm). Best corrected visual acuity(BCVA),endothelial cells density(ECD) and complications were assessed and comparisons were done between groups.RESULTS: Median thickness of postoperative grafts was 188(range 73-317 μm). There was no significant difference in age, sex, preoperative BCVA, or follow-up period between DSAEK groups. At postoperative 12 mo,mean BCVA was 0.28±0.10 in thick graft group, 0.52±0.08 in medium-thick graft group, and 0.72 ±0.06 in thin graft group. Thin grafts showed better postoperative BCVA as compared with the medium-thick and thick grafts(P =0.001). Thick graft group had 1637.44 ±88.19-mm2,medium thick graft had 1764.50±34.28-mm2 and thin graft group had 1845.30 ±65.62-mm2. Thin graft group had better ECD at 12 mo after surgery(P =0.001).CONCLUSION: Thin grafts after DSAEK ensure better visual rehabilitation. Eyes with thin grafts had significantly lesser loss of ECD compared to eyes withmedium-thick and thick grafts one year after surgery.

Proliferation of endothelial cell on polytetrafluoroethylene vascular graft materials carried VEGF gene plasmid

Objective： To investigate whether vascular endothelial growth factor （VEGF） gene plasmid carried by polytetrafluoroethylene （PTFE） vascular graft materials could transfect endothelial cells （ECs） and promote their growth. Methods： PTFE vascular graft materials carried with pCDI-hVEGF121, pCDI or pEGFP were incubated in Tris-buffer solution and the values of optical density of 260 nm at different time were plotted, then the DNA controlled release curve was made. ECs derived from human umbilical vein were seeded on the pCDI-hVEGF121/pCDI/pEGFP-PTFE materials or tissue culture plates, ECs numbers were counted and VEGF protein concentrations at different time were measured by enzyme-linked immunoadsorbent assay method. Green fluorescent protein （GFP） expression in ECs on pEGFP-PTFE materials was examined with fluorescence mi- croscopy. Results： The controlled release curve showed that the gene released from PTFE materials was rapid within 8 h, then slowed down and that the gene released continuously even after 72 h. At 24, 72 and 120 h, ECs number and proliferation rate of pCDI-hVEGFI21-PTFE materials were higher than those ofpCDI or pEGFP-PTFE materials （P〈0.05）. VEGF protein concentration of pCDI-hVEGF121-PTFE materials was higher than that of pC DI or pEGFP-PTFE materials at 6, 24, 72 and 120 h （P〈0.01）. GFP expression in ECs on the pEGFP-PTFE materials could be detected by fluorescence microscopy. Conclusion： PTFE graft can be used as a carrier of VEGF gene plasmid, VEGF gene carried by PTFE can transfect ECs and promote ECs growth.

Simultaneous tectonic Descemet stripping endothelial keratoplasty and tectonic Bowman layer transplant for the management of corneal perforation

AIM:To report the outcomes of three cases of corneal perforation managed with simultaneous tectonic Descemet stripping endothelial keratoplasty(t-DSEK)and tectonic Bowman layer transplant(t-BLT)as an alternative to tectonic penetrating keratoplasty(t-PKP).METHODS:Three eyes of three patients receiving simultaneous t-DSEK and t-BLT for corneal perforation were included.The technique for DSEK was modified depending on individual requirements.The t-BLT technique was standardised using an 8 mm graft and fixated with a running suture.Success was measured by the ability of this procedure to close a corneal perforation.RESULTS:All three cases achieved tectonic eye globe restoration and remained stable during the minimum 3-month observation period.Reinterventions were relatively common:2 cases required amniotic membrane transplant for persistent epithelial defects.One case required DSEK rebubbling.One case developed angle closure glaucoma requiring surgical peripheral iridectomy.CONCLUSION:Simultaneous t-DSEK and t-BLT may be a useful strategy for the management of corneal perforation as an alternative management to t-PKP for selected cases.

Modified thin manual Descemet stripping endothelial keratoplasty with air-guided, non-pachymetric donor lenticule dissection: outcomes of graft thickness and complication rate

●AIM:To describe a modified technique of donor lenticule dissection for thin manual Descemet stripping endothelial keratoplasty(TM-DSEK).●METHODS:Donor material was soaked in balanced salt solution(BSS)for 30 min,before being mounted on an artificial anterior chamber(AAC).Rather than BSS,the AAC was filled with filtered air,resulting in a visible reflection at the corneal endothelium-air interface.This reflection served as a landmark for the depth of the dissection,facilitating the creation of a thin lenticule with low risk of perforation.Dissection was commenced at a standardized depth of 500 microns,with no initial pachymetry necessary.Totally 29 donor corneas were dissected by a novice TM-DSEK surgeon.Dissection time,central graft thickness at 2 mo and complications were analysed.●RESULTS:Results were similar to other endothelial keratoplasty techniques,despite the cases being performed by a novice DSEK surgeon.Mean dissection time was 7 min(range 6-10).One graft perforation occurred(3.45%),but the air tamponaded the break and enabled dissection to be restarted and completed from a different location.Mean central graft thickness after at least two months follow-up was 106 microns(range 25-170).●CONCLUSION:A problem with manual DSEK is the risk of graft perforation by attempting to dissect too thin a lenticule,or creating a thick graft due to fear of perforating.This modified air-guided technique addresses this problem,and is recommended for surgeons either embarking on the learning curve,or who wish to achieve more consistently thin grafts while reducing perforation rates.

Suturing Technique to Promote Graft Attachment in Challenging Cases of Descemet Stripping Endothelial Keratoplasty

Aims: To describe a technique that uses a transcorneal fixation suture for graft attachment in endothelial keratoplasty in high-risk for graft dislocation eyes. Materials and Methods: Case series included 12 eyes of 12 patients who underwent Descemet Stripping Automated Endothelial Keratoplasty (DSAEK) in the presence of high risk for graft dislocation factors. We describe a surgical technique that uses a transcorneal fixation suture to compress the donor graft onto the back surface of the recipient cornea. Outcome measures included intraoperative and postoperative complications, graft attachment and clarity and endothelial cell count at a 12 months follow-up period. Results: No intraoperative complications were noted and 11 grafts remained attached and clear with no suture related complications at a 12-month follow-up period. Partial peripheral graft detachment due to suture related graft folds, accompanied by mild corneal edema was noticed in one patient postoperatively. Reattachment and edema resolution occurred spontaneously after suture removal. The mean endothelial cell loss was 38.21% at 12 months. Conclusions: Temporary transcorneal fixation suture can be helpful in preventing graft detachment in eyes with high risk for graft dislocation.

A Novel Y-Suture Transfixation Technique to Improve Graft Adherence in High-Risk Descemets Stripping Automated Endothelial Keratoplasty

Purpose: To report a novel Y-suture transfixation technique to improve success rate of high-risk Descemets stripping automated endothelial keratoplasties (DSAEK). Design: Retrospective non-comparative case series. Participants: Twenty five high-risk patients undergoing DSAEK at one tertiary care institution. Methods: A retrospective evaluation of consecutively enrolled high-risk DSAEK cases performed by three surgeons at one institution during a 3-year period (2007-2010). Main outcome measures were graft adherence and suture-related complications. Results: Highrisk factors were defined as followed: prior incisional glaucoma surgery (58%), presence of vitreous in the anterior chamber (15%), anterior chamber intraocular lens (8%), graft dislocation (8%), previous DSAEK (8%), and iris trauma/aphakia (3%). Twenty-five high-risk patients underwent DSAEK with Y-suture transfixation. Postoperative follow-up ranged from 3 to 27 months. One patient had dislocation due to hypotony from prior trabeculectomy (4%), requiring repeat DSAEK. Neither primary graft failure nor suture-related complication was observed. Conclusion: The Y-suture transfixation technique is associated with improved success rate of high-risk DSAEK transplant.

A 5-year analysis of endothelial vs penetrating keratoplasty graft survival in Chinese patients

AIM:To determine if there is any difference in longterm graft survival between Descemet’s stripping endothelial keratoplasty(DSEK)and penetrating keratoplasty(PK).METHODS:A retrospective 5-year cases analysis of bullous keratopathy secondary to Fuchs’endothelial dystrophy or pseudophakic bullous keratopathy,receiving either DSEK or PK.A total of 42 DSEK cases and 25 PK cases were included in the analysis.RESULTS:In the 5-year analysis,graft survival rates were very similar in the two groups(DSEK 77.1%vs PK76.0%.P=0.918.95%CI:-6.3 to 33.4).Sub-analyses at 1y(DSEK 81%vs PK 95%.P=0.085.95%CI:-29 to 3.6)and 2y(DSEK 81%vs PK 88%.P=0.381.95%CI:-25.9 to 11.8)show a trend towards lower survival rates of DSEK vs PK,but the results were not statistically significant.CONCLUSION:Longterm 5-year graft survival is similar between the DSEK and PK methods of corneal transplant in Chinese patients with bullous keratopathy.

Downregulation of transforming growth factor-<i>β</i>(TGF-<i>β</i>) and vascular endothelial growth factor (VEGF) in ehrlich ascites carcinoma-bearing mice using stearic acid-grafted carboxymethyl chitosan (SA-CMC)

The present study was conducted to investigate the use of stearic acid-grafted carboxymethyl chitosan(SA-CMC) as a downregulator for trans- forming growth factor-β (TGF- β) and vascular endothelial growth factor (VEGF) in Ehrlich ascites carcinoma (EAC)-bearing mice. The antitumor effect of stearic acid-grafted carboxymethyl chitosan was assessed by the estimation of TGF- β and VEGF in serum in addition to the estimation of tumor volume, median survival time (MST), percentage of increase in life span (ILS%) as well as the contents of total lipid, DNA and RNA in liver tissues. Hematological profiles (hemoglobin, red blood cells, and platelets) were also assessed. In addition, liver function tests and the redox status were estimated. TGF- β, VEGF, DNA, RNA, and malondialdehyde (MDA) levels, in addition to serum alanine transaminase (ALT) and gamma glutamyl transferase (GGT) activities as well as total white blood cells counts and tumor volume were all highly significantly increased (P < 0.001) in untreated EAC-bearing mice compared to controls. However, hematological profiles, total lipid in liver tissues and serum albumin were highly decreased in EAC-bearing mice compared to controls. All these parameters were restored to the normal levels in SA-CMC treated EAC-bearing mice com- pared to the untreated EAC-bearing mice. It is thus concluded that stearic acid-grafted carboxymethyl chitosan has a remarkable antitumor activity against EAC in Swiss albino mice through downregulation of TGF-β and VEGF.

Fucoidan and topography modification improved in situ endothelialization on acellular synthetic vascular grafts

Thrombogenesis remains the primary failure of synthetic vascular grafts.Endothelial coverage is crucial to provide an antithrombogenic surface.However,most synthetic materials do not support cell adhesion,and transanastomotic endothelial migration is limited.Here,a surface modification strategy using fucoidan and topography was developed to enable fast in situ endothelialization of polyvinyl alcohol,which is not endothelial cell-adhesive.Among three different immobilization approaches compared,conjugation of aminated-fucoidan promoted endothelial monolayer formation while minimizing thrombogenicity in both in vitro platelet rich plasma testing and ex vivo non-human primate shunt assay.Screening of six topographical patterns showed that 2μm gratings increased endothelial cell migration without inducing inflammation responses of endothelial cells.Mechanistic studies demonstrated that fucoidan could attract fibronectin,enabling integrin binding and focal adhesion formation and activating focal adhesion kinase(FAK)signaling,and 2μm gratings further enhanced FAK-mediated cell migration.In a clinically relevant rabbit carotid artery end-to-side anastomosis model,60%in situ endothelialization was observed throughout the entire lumen of 1.7 mm inner diameter modified grafts,compared to 0%of unmodified graft,and the four-week graft patency also increased.This work presents a promising strategy to stimulate in situ endothelialization on synthetic materials for improving long-term performance.

贻贝仿生聚酚胺涂层固定REDV短肽促内皮化探究

药物洗脱支架(DES)的发展显著降低了支架的再狭窄率,但引入的药物会不可避免地造成内皮层的损伤,从而影响病灶部位内皮屏障的完整性和功能性。结构完整及功能正常的血管内皮细胞层是维持血管组织稳态以及凝血系统平衡的重要保障。使用兼具优良血液相容性及促内皮化功能的涂层对支架进行预处理,是改善血管支架等心血管植入器械并发症的有效策略。本研究选用氧化剂高碘酸钠加速多巴胺自聚合,使其在支架材料表面快速形成聚酚胺涂层PDA,制备方法简单且省时;随后通过迈克尔加成反应点击接枝功能性短肽REDV,构建促内皮化涂层P-REDV,REDV肽接枝效率高且接枝密度大(9.84 ng/cm^(2))。该涂层在体外细胞培养实验中对内皮细胞粘附具有选择性促进作用,同时显示出优异的血液相容性,为解决药物洗脱支架及心血管植入器械延迟内皮化的问题提供了一种新的策略。

Advances in the differentiation of pluripotent stem cells into vascular cells

Blood vessels constitute a closed pipe system distributed throughout the body,transporting blood from the heart to other organs and delivering metabolic waste products back to the lungs and kidneys.Changes in blood vessels are related to many disorders like stroke,myocardial infarction,aneurysm,and diabetes,which are important causes of death worldwide.Translational research for new appro-aches to disease modeling and effective treatment is needed due to the huge socio-economic burden on healthcare systems.Although mice or rats have been widely used,applying data from animal studies to human-specific vascular physiology and pathology is difficult.The rise of induced pluripotent stem cells(iPSCs)provides a reliable in vitro resource for disease modeling,regenerative medicine,and drug discovery because they carry all human genetic information and have the ability to directionally differentiate into any type of human cells.This review summarizes the latest progress from the establishment of iPSCs,the strategies for differentiating iPSCs into vascular cells,and the in vivo trans-plantation of these vascular derivatives.It also introduces the application of these technologies in disease modeling,drug screening,and regenerative medicine.Additionally,the application of high-tech tools,such as omics analysis and high-throughput sequencing,in this field is reviewed.

移植物厚度对角膜内皮失代偿行简易后弹力层角膜内皮移植效果的影响

背景:研究表明较薄移植物视力恢复更快、排斥风险更低,国内缺乏对内皮移植术后不同植片厚度的临床疗效分析,因此,确定最佳移植物厚度对于提高手术疗效至关重要。目的:评价简易后弹力层剥离内皮角膜移植术后不同植片厚度对视力恢复及其他预后指标的影响。方法:选取2013年1月至2023年2月在北部战区总医院接受简易后弹力层剥离内皮角膜移植手术治疗的角膜内皮失代偿患者共72例(72眼),其中薄植片组(<100μm)32例(32眼),厚植片组(≥100μm)40例(40眼)。随访1年,观察两组术前及术后1,3,6,12个月的最佳矫正视力,术后1年角膜内皮细胞数、角膜植片透明度、术后并发症、植片生存情况。结果与结论:①两组患者术后视力较术前均有显著提高,薄植片组患者术后3个月最佳矫正视力优于厚植片组(P<0.05);②两组术后1年角膜内皮细胞数及植片透明度比较差异无显著性意义(P>0.05);③两组患者继发性青光眼、植片免疫排斥、植片移位等术后并发症发生率比较差异无显著性意义(P>0.05);④两组术后1年植片生存率比较差异无显著性意义(93.8%,92.3%,P>0.05);⑤结论:简易后弹力层剥离内皮角膜移植术是一种安全有效的角膜内皮移植手术方式,其术后疗效与传统后弹力层剥离内皮角膜移植术相似,而且植片植入方式更为简便。较薄植片能够更早提供最佳矫正视力,更早完成角膜重塑,因此在治疗角膜内皮失代偿疾病时,优先选择薄移植物来提高恢复时间。

经皮扩张式铰刀髓芯减压联合PRO-DENSE可再生骨植骨治疗股骨头坏死的疗效及安全性分析

目的探究经皮扩张式铰刀髓芯减压联合PRO-DENSE可再生骨植骨术在股骨头坏死(ONFH)治疗中的应用价值。方法回顾性选取2020年1月1日—2022年1月1日100例ONFH,根据手术方法分为2组各50例。对照组行髓芯减压自体骨植骨术,观察组行经皮扩张式铰刀髓芯减压联合PRO-DENSE可再生骨植骨术。比较2组手术观察指标、手术疗效、并发症发生情况,以及手术前后神经源性炎症指标[神经生长因子(NGF)、前列腺素E_(2)(PGE_(2))]、血清生化指标[缺氧诱导因子-1α(HIF-1α)、血管内皮生长因子A(VEGF-A)、Ⅰ型前胶原氨基酸前肽(PⅠNP)、骨钙素(BGP)]、视觉模拟量表(VAS)评分、Harris髋关节功能评分。结果观察组术中出血量(24.25±4.78)mL少于对照组(50.29±8.94)mL,住院时间(12.50±2.24)d短于对照组(15.12±3.37)d(P<0.01)。观察组术后1、3及7 d血清NGF、PGE_(2)低于对照组(P<0.05)。观察组术后1、3及6个月血清HIF-1α、VEGF-A、BGP及Harris髋关节功能评分较对照组高,血清PⅠNP及VAS评分较对照组低(P<0.05)。2组手术优良率、并发症总发生率比较,差异无统计学意义(P>0.05)。结论经皮扩张式铰刀髓芯减压联合PRO-DENSE可再生骨植骨术是ONFH患者安全可靠的治疗方式,能降低炎性因子水平,促进术后早期恢复,加速骨代谢,促进髋关节功能恢复,减轻患者疼痛。

深板层角膜移植与穿透性角膜移植治疗基质角膜营养不良预后的比较

背景:基质角膜营养不良的传统手术治疗方式为穿透性角膜移植,近年来越来越多的医生开始考虑使用深板层角膜移植治疗基质角膜营养不良。目前国内对比穿透性角膜移植和深板层角膜移植治疗基质角膜营养不良的研究少有报道。目的:比较深板层角膜移植和穿透性角膜移植治疗基质角膜营养不良的疗效。方法:选择2000年1月至2018年1月北部战区总医院收治的基质角膜营养不良患者57例(57眼),男18例,女39例,平均年龄(52.9±20.0)岁,按照手术治疗方式分为深板层角膜移植组(n=21)、穿性角膜移植组(n=36),术后随访观察最佳矫正视力、角膜内皮细胞密度、角膜植片透明度、术中及术后并发症、原病复发情况。结果与结论:①两组患者术后1,3,6,12个月的视力均高于术前(P<0.05),两组间术后不同时间点的视力比较差异无显著性意义(P>0.05);随着术后时间的延长,两组患者角膜内皮细胞密度逐渐降低,穿透性角膜移植组患者术后6,12个月的角膜内皮细胞密度年丢失率均高于深板层角膜移植组(P<0.05);两组患者术后12个月的角膜植片透明率比较差异无显著性意义(P>0.05);②深板层角膜移植组有6例出现并发症,穿透性角膜移植组有14例出现并发症,57例患者术后12个月内均无复发,两组患者术后5年的复发率比较差异无显著性意义(P>0.05),穿透性角膜移植组和深板层角膜移植组术后5年的移植物存活率分别为83%和86%,组间比较差异无显著性意义(P>0.05);③结果表明,基质角膜营养不良的治疗可考虑使用深板层角膜移植替代一部分穿透性角膜移植。

通心络胶囊对冠状动脉搭桥患者血管内皮功能及不良心血管事件的影响

目的分析通心络胶囊对冠状动脉搭桥患者血管内皮功能及不良心血管事件的影响。方法选取2020年1月~2022年1月收治的择期行冠状动脉搭桥术的冠心病患者100例,筛选后分为两组,各50例。对照组接受阿司匹林、氯吡格雷及他汀类等药物治疗,观察组加用通心络胶囊,均治疗并随访3个月。比较临床指标。结果观察组、对照组移植血管数、术后引流量、手术时间比较,均无明显差异,P>0.05;经比较两组治疗1个月后、治疗3个月后的血清ET-1水平、血浆FIB、MPV水平较治疗前逐渐降低,观察组均低于对照组,治疗1个月后、治疗3个月后的血清NO水平、LVEF水平较治疗前逐渐升高,观察组均高于对照组,观察组患者随访期间不良心血管事件发生率低于对照组(P<0.05)。结论通心络胶囊可有效改善冠状动脉搭桥患者血管内皮功能,改善其血液凝固状态,促进心功能的恢复,降低不良心血管事件的发生风险,临床应用效果显著。