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Cellular senescence is a response process in which cells are activated by ischemia, hypoxia, oxidative stress, DNA damage, reactive oxygen species deposition and other stimulations.Senescent cells markers include such as senescence-associated β-galactosidase (SA-β-gal) activation, P16INK4a upregualtion, senescence-associated heterochromatic foci (SAHF) accumulation, senescence-associated secretory phenotype (SASP) generation, telomere shortening and so on.P16INK4a/Rb and P19 ARF/P53/P21 Cip1 pathways are two classic cell senescence signaling pathways, which are interconnected and independent on each other.In recent years, glaucoma is considered as a blinding eye disease associated with cell senescence.Research on cell senescence in glaucoma mainly focuses on trabecular meshwork and Schlemm cannel endothelial cells senescence leading to increased resistance of aqueous humor outflow pathway, and the mechanism of retinal ganglion cells senescence and treatment in glaucoma.As an irreversible stage before cell death, deeper study on the mechanism of retinal ganglion cells senescence, and specific blocking of cell senescence will provide a new target for reducing the aqueous humor outflow resistance and protecting the optic nerve in glaucoma.This article reviewed characteristics, inducements, molecular signaling pathways of cellular senescence in glaucoma.
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Objective:To investigate the degenerative characteristics and biomechanical effects of paravertebral muscles in patients with degenerative lumbar scoliosis.Methods:The clinical data of 236 patients with degenerative lumbar scoliosis from January 2016 to January 2020 in Yuncheng Central Hospital of Shanxi Province were retrospectively analyzed. All patients underwent lumbar X-ray and MRI measurement, and the indexes included coronal scoliosis Cobb angle, rotation classification of apical vertebra, cross-sectional area (CSA) of the apical vertebra upper and lower intercalated disc plane, fatty infiltration rate (FIR) of psoas major and back extensor muscle group (including erector spinae and multifidus muscle), cross-sectional area difference index (CDI) and fatty infiltration difference (FID). The correlation between paravertebral muscle degeneration and coronal scoliosis Cobb angle was evaluated.Results:The coronal scoliosis Cobb angle of 236 patients was 10.4° to 57.8° (18.72 ± 6.44)°; there were no statistical differences in coronal scoliosis Cobb angle and rotation classification of apical vertebra between different sex, scoliosis direction and apical vertebra position ( P>0.05). In the apical vertebra upper intercalated disc plane, the concave side CSA of psoas major muscle was significantly higher than convex side: (3.82 ± 1.06) cm 2 vs. (3.68 ± 1.01) cm 2, the concave side CSA of multifidus muscle, back extensor muscle group and paraspinal muscle group (including psoas major muscle, quadratus lumborum, erector spinae and multifidus muscle) was significantly lower than convex side: (9.80 ± 2.14) cm 2 vs. (10.46 ± 2.60) cm 2, (18.18 ± 3.03) cm 2 vs. (19.79 ± 3.22) cm 2 and (25.25 ± 5.06) cm 2 vs. (27.86 ± 6.90) cm 2, and there were statistical differences ( P<0.05 or <0.01); there were no statistical differences in CSA of quadratus lumborum and erector spinae between concave side and convex side ( P>0.05). In the apical vertebra lower intercalated disc plane, the concave side CSA of psoas major muscle and quadratus lumborum was significantly higher than convex side: (6.62 ± 3.09) cm 2 vs. (6.40 ± 3.23) cm 2 and (4.58 ± 0.57) cm 2 vs. (4.45 ± 0.64) cm 2, the concave side CSA of multifidus muscle and back extensor muscle group was significantly lower than concave side: (9.49 ± 3.10) cm 2 vs. (10.32 ± 4.06) cm 2 and (19.31 ± 4.36) cm 2 vs. (20.54 ± 5.60) cm 2, and there were statistical differences ( P<0.01 or <0.05); there was no statistical difference in CSA of erector spinae and paraspinal muscle group between concave side and convex side ( P>0.05). In apical vertebra upper and lower intercalated disc plane, the concave side FIR of back extensor muscle group was significantly higher than convex side: (31.83 ± 11.04)% vs. (24.37 ± 12.76)% and (38.62 ± 10.09)% vs. (31.80 ± 8.23)%, and there was statistical difference ( P<0.01); there was no statistical difference in FIR of psoas major muscle between concave side and convex side ( P>0.05). Pearson linear correlation analysis result showed that CDI of multifidus muscle, back extensor muscle group, paraspinal muscle group and FID of back extensor muscle group were positively correlated with coronal scoliosis Cobb angle (apical vertebra upper intercalated disc plane: r = 0.94, 0.70, 0.86 and 0.90, P<0.01; apical vertebra lower intercalated disc plane: r = 0.92, 0.94, 0.81 and 0.66, P<0.01); the CDI of psoas major muscle in apical vertebra lower intercalated disc plane was positively correlated with coronal scoliosis Cobb angle ( r = 0.73, P<0.01); there was no correlation between CDI of psoas major muscle in apical vertebra upper intercalated disc plane and coronal scoliosis Cobb angle ( r = 0.17, P>0.05). In patients with apical vertebra located in L 2 and L 3, the CSA of psoas major muscle and quadratus lumborum in apical vertebra lower intercalated disc plane was significantly higher than that in apical vertebra upper intercalated disc plane, and there was statistical difference ( P<0.01); in patients with apical vertebra located in L 2, the concave side CSA of erector spinae in apical vertebra lower intercalated disc plane was significantly higher than that in apical vertebra upper intercalated disc plane, and there was statistical difference ( P<0.01). Conclusions:The biomechanical effects of lumbar flexion/ back extensor muscle group should be different in the process of disease progression in patients with degenerative lumbar scoliosis, in which the back extensor muscle group can effectively inhibit the degenerative disease. The protection of paravertebral muscle group function should be placed in an important role in degenerative lumbar scoliosis treatment.
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OBJECTIVE:To observe therapeutic efficacy and safety of tobramycin dexamethasone in the treatment of meibo-mian gland dysfunction(MGD). METHODS:108 MGD patients were randomly divided into control group(53 cases)and observa-tion group(55 cases). Control group was given eyelid cleaning with conventional physical cleaning method,at the same time,giv-en Doxycycline hydrochloride tablets 0.1 g orally after meal,twice a day. Based on control group,observation group was addition-ally given Tobramycin and dexamethasone eye ointment with length of 1.0-1.5 cm,smearing into conjunctival sac,4 times a day. Treatment courses of 2 groups lasted for 4 weeks. Clinical efficacies of 2 groups were observed as well as eyelid observation score, symptom score,the levels of IL-6 and TNF-α,the occurrence of ADR before and after treatment. RESULTS:The total response rate of observation group was significantly higher than that of control group(89.1% vs. 77.4%),with statistical significance(P0.05). After treatment,eyelid observation score of 2 groups were significantly higher than before treatment,and the observation group was significantly higher than the control group;symptom score and the levels of IL-6 and TNF-α in 2 groups were significantly lower than before treatment,and the observation group was significantly lower than the con-trol group,with statistical significance(P0.05). CONCLUSIONS:Based on routine treatment,tobramycin dexamethasone shows significant therapeutic efficacy for MGD,and can improve clinical symptoms significantly but does not increase the occurrence of ADR.