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Neuro-ophthalmology,as an interdisciplinary,covers ophthalmology,neurology and neurosurgery.In China,the development of neuro-ophthalmology has just started,therefore how to train neuro-ophthalmological specialists in China is a problen.This paper analyzed the medical education and current situation of neuro-ophthalmology of China and America,discussed the differences between them,and then put forward some problems existing in the neurological ophthalmology physician training and solutions,aiming at improving the specialist physician train program of Neuro-ophthalmology by learing from foreign medical education development experience,and promoting the development of neuro-ophthalmology in China.
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BACKGROUND: The tissue engineered corneal epithelium can be constructed with limbal stem cells of healthy rabbit cornea cultured in vitro, and its transplantation may promote the repair and healing of corneal alkaline burn.OBJECTIVE: To probe the effect and opportunity of treating corneal alkaline bum by tissue-engineered corneal epithelium transplantation.DESIGN, TIME AND SETTING: Controlled observational animal experiment was performed in the Department of Experimental Animal at the First Affiliated Hospital of Chinese PLA General Hospital between July 2007 and June 2008.MATERIALS: Twenty-one New Zealand female white rabbits, weighing 2.0-2.5 kg, were divided into control group (n=8, 16 eyes) and transplantation group (n=13, 26 eyes) at random. The transplantation group was further assigned into early transplantation group at 1 day (n=2, 4 eyes), 3 days (n=3, 6 eyes), 6 days (n=6, 12 eyes), and 9 days (n=9, 18 eyes); and mataphase transplantation group at 14 days (n=3, 6 eyes).METHODS: The tissue-engineered corneal epithelium was prepared on 21 rabbits with limbal stem cells cultured in vitro, and reforming comeel alkaline burn models of double eyes were induced by 1 mollL NaOH. The autotogous or allogenic tissue-engineered comeal epithelium transplantation was conducted on early time points (1, 3, 6, 9 days) or metaphase (14 days) after alkaline burning. In the control group, the burns were observed for 4 consecutive weeks.MAIN OUTCOME MEASURES: The ocular surface integrity and histopathology in the transplantation group and control group were observed on several time points within 4 weeks.RESULTS: At 1 weak after corneal alkaline burning, large corneal epithelial dasquamation occurred, 72% incidence of epithelial desquamation or corneal ulcer at 2 weeks, and continued to 4 weeks, while only 25% were observed at 4 weeks in transplantation group, most gained ocular surface integrity; cell infiltration and vascularization of corneal stroma had not bean suppressed in metaphase transplantation group, while they were suppressed obviously in the deep comeal stroma in early transplantation groups; Within 4 weeks, immunological rejection induced by allogenic transplantation was not greater than that of autologous transplantation.CONCLUSION: Cultivated autologous or allogenic tissue-engineered corneal epithelium transplantation could recover ocular surface integrity as soon as possible, and the effect of early transplantation surpasses that of mstaphase.
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Objective To detemine the effect of autografts of in-vitro cultured corneal limbal stem cells for treating pterygium. Methods A total of 11 cases (12 eyes) with pterygium were treated with autograft of in-vitro cultured corneal limbal stem cells and were followed-up for 6-15 months. Results During the follow-up pterygium recurred in 1 eye (8.33 %) . All of the grafts survived well and no immunological rejection or other complication occurred. Conclusion Autograft of in vitro cultured corneal limbal stem cells is an effective and valuable method to treat pterygium.
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Objective To observe the time of occurance,morphologic characteristics,and development of the retinal neurons' apoptosis of the early phase indiabetic rats. Design Experimental study. Participants Sprague-Dawley (SD) rats. Methods In 36 male SD rats of 8-week old,18 were diabetic models induced by streptozotocin injection,and 18 normal ones as control. Each group were subdivided into 3 groups (each group,n=6),in which the rats were sacrificed at 4,8 and 12 weeks,respectively. The pathological change of the retina,and the retinal neurons ultrastructure were observed. Apoptosis of the retinal neurons was also examined by TdT-mediated dUTP nick end label (TUNEL) assay. Main Outcome Measures The pathological retinal structure,the ultrastructure of retinal neurons,and the apoptosis of the retinal neurons in each group. Results No obvious structural changes of retina were found pathologically in diabetic rats of 4-week and 8-week,comparing with age-matched control group. However decreased retinal ganglion cell number and thinner inner nuclear layer were observed in diabetic rats of 12 weeks. Apoptosis defined by electron microscope,including cell shrinkage,reduced cell volume,chromatin margination and nuclear shrinkage and collapse,was found in each subgroup of diabetic rats. Apoptosis in the retinal ganglion cells layer and the inner nuclear layer was dominant. The apoptosis of the retinal neurons by TUNEL assay occurred at 4 weeks after onset of diabetes,and the number of the apoptosis neurons increased at 8 and 12 weeks in diabetic rats,the apoptosis neurons mainly located in the retinal ganglion cells layer and the inner nuclear layer. Conclusion Apoptosis of the retinal neurons occurred at 4 weeks after onset of diabetes and the degree of the apoptosis was correlated with the process of disease in rat model.