Calpain II induced insolubilization of lens β-crystallin polypeptides may induce cataract

Addition of calpain II (EC 3.4.22.17) to soluble proteins from 10-day-old rat lens caused an increase in turbidity and production of water-insoluble protein. The insolubilization increased with higher concentrations of both lens protein and calpain II, it could be prevented by the cysteine protease inhibitor E-64; it required at least 0.5 mM Ca²⁺, it was limited to 6% of the soluble protein present and resulted from precipitation β-crystallin polypeptides. When compared by two-dimensional electrophoresis, the insoluble β-crystallin polypeptides produced by calpain II were similar to insoluble β-crystallin polypeptides found incataractous lenses. Trypsin also caused insolubilization of β-crystallin polypeptides, but these polypeptides were unlike polypeptides produced during cataract formation. These data suggested that the loss of solubility was due to a specific removal of N/or C-terminal extensions from β-crystallin polypeptides by calpain II, and that a similar process may occur in vivo during cataract formation. It is hypothesized that the insoluble protein produced by calpain II causes cataract by increasing light scatter in the lens.     

三硝基甲苯对大鼠晶状体中可溶性蛋白质、巯基及二硫键含量的影响

我们采用三硝基甲苯（ＴＮＴ）与大鼠晶状体体外培养的方法,动态观察了晶状体中可溶性蛋白质、非蛋白质巯基、蛋白质巯基、蛋白质结合巯基及二硫键含量的变化,发现随着三硝基甲苯作用时间的延长,可溶性蛋白质、非蛋白质巯基及蛋白质巯基均减少,蛋白质结合巯基及二硫键交联的蛋白质含量增加,其中可溶性蛋白质、非蛋白质巯基及二硫键含量的变化皆达到了统计学上显著意义水平（Ｐ＜０．０５）。     

四种中草药对大鼠半乳糖性白内障氧化还原物质及糖类含量的影响

对正常和半乳糖性白内障及给中草药的大鼠晶状体中某些吡啶核苷酸成分、糖类、非蛋白质巯基的含量进行了比较。结果表明,在白内障晶状体中,NADPH及非蛋白质巯基的含量明显低于正常晶状体的,而NADP、半乳糖及半乳糖醇的含量明显高于正常晶状体的;当注射半乳糖的同时分别用黄岑、石斛、菟丝子及玉蝴蝶四种中草药水煎剂灌胃,上述变化为基本恢复至正常晶状体的水平。表明四种中草药对晶状体中的异常生化变化具有阻止及纠正作用。     

不同切口超声乳化术联合小梁切除术对白内障合并青光眼患者视力、角膜内皮细胞及生活质量的影响

摘要 目的：探讨不同切口超声乳化术联合小梁切除术对白内障合并青光眼患者视力、角膜内皮细胞及生活质量的影响。方法：回顾性分析2018年4月~2019年7月期间我院收治的150例白内障合并青光眼患者的临床资料,根据手术方式的不同分为A组（n=75,单切口超声乳化术联合小梁切除术）和B组（n=75,双切口超声乳化术联合小梁切除术）。比较两组患者眼压、裸眼视力、最佳矫正视力、角膜内皮细胞、生活质量及并发症。结果：两组术后3个月健康调查简表(SF-36)各维度评分均升高,且B组高于A组（P<0.05）。两组术后3个月眼压均降低,且B组低于A组（P<0.05）;两组术后3个月裸眼视力和最佳矫正视力均升高,且B组高于A组（P<0.05）。两组术后3个月角膜内皮细胞面积均增加,但B组小于A组（P<0.05）;角膜内皮细胞密度均下降,但B组高于A组（P<0.05）。B组术后并发症总发生率低于A组（P<0.05）。结论：与单切口超声乳化术联合小梁切除术相比,白内障合并青光眼患者采用双切口超声乳化术联合小梁切除术治疗,在改善患者眼压、裸眼视力、最佳矫正视力、角膜内皮细胞、生活质量及减少并发症发生率方面的效果更佳。     

Accumulation of the hydroxyl free radical markers meta-, ortho-tyrosine and DOPA in cataractous lenses is accompanied by a lower protein and phenylalanine content of the water-soluble phase

Post-translational modifications of lens proteins play a crucial role in the formation of cataract during ageing. The aim of our study was to analyze protein composition of the cataractous lenses by electrophoretic and high-performance liquid chromatographic (HPLC) methods.

Samples were obtained after extracapsular cataract surgery performed by phacoemulsification technique from cataract patients with type 2 diabetes mellitus (DM CAT, n = 22) and cataract patients without diabetes (non-DM CAT, n = 20), while non-diabetic non-cataractous lenses obtained from cadaver eyes served as controls (CONTR, n = 17). Lens fragments were derived from the surgical medium by centrifugation. Samples were homogenized in a buffered medium containing protease inhibitor. Soluble and insoluble protein fractions were separated by centrifugation. The electrophoretic studies were performed according to Laemmli on equal amounts of proteins and were followed by silver intensification. Oxidized amino acid and Phe content of the samples were also analyzed by HPLC following acid hydrolysis of proteins.

Our results showed that soluble proteins represented a significantly lower portion of the total protein content in cataractous lenses in comparison with the control group (CONTR, 71.25%; non-DM CAT, 32.00%; DM CAT, 33.15%; p < 0.05 vs CONTR for both). Among the proteins, the crystallin-like proteins with low-molecular weight can be found both in the soluble and insoluble fractions, and high-molecular weight aggregates were found mainly in the total homogenates. In our HPLC analysis, oxidatively modified derivatives of phenylalanine were detected in cataractous samples. We found higher levels of m-Tyr, o-Tyr and DOPA in the total homogenates of cataractous samples compared to the supernatants. In all three groups, the median Phe/protein ratio of the total homogenates was also higher than that of the supernatants (total homogenates vs supernatants, in the CONTR group 1102 vs 633 μmol/g, in the DM CAT group 1187 vs 382 μmol/g and in the non-DM CAT group 967 vs 252 μmol/g; p < 0.05 for all).

In our study we found that oxidized amino acids accumulate in cataractous lenses, regardless of the origin of the cataract. The accumulation of the oxidized amino acids probably results from oxidation of Phe residues of the non-water soluble lens proteins. We found the presence of high-molecular weight protein aggregates in cataractous total homogenates, and a decrease of protein concentration in the water-soluble phase of cataractous lenses. The oxidation of lens proteins and the oxidative modification of Phe residues in key positions may lead to an altered interaction between protein and water molecules and thus contribute to lens opacification.     

超声乳化白内障吸除、人工晶状体植入联合小梁切除术治疗白内障合并青光眼的临床疗效及安全性评价

目的：探讨超声乳化白内障吸除、人工晶状体植入联合小梁切除术治疗白内障合并青光眼的临床疗效及安全性。方法：将100例白内障合并青光眼患者按照抽签法随机地均分为对照组与观察组,对照组给予单纯超声乳化人工晶状体植入术,观察组在此基础上给予联合小梁切除术进行治疗。比较两组治疗前后相关指标以及术后并发症发生率等。结果：（1）对照组治疗前后IOP、ACD及AL均无统计学差异,观察组治疗前后IOP与CAD差异具有统计学意义（P〈0．05,P〈0．01）,但该组治疗前后AL无统计学差异;（2）两组术前与术后1周、1个月及3个月平均视野缺损值、平均模式标准差相比,差异均具有统计学意义,且观察组术后与对照组术后相比,差异均具有统计学意义;（3）对照组并发症发生率为20．00％,明显大于观察组（10．00％）。结论：超声乳化白内障吸除、人工晶状体植入联合小梁切除术治疗白内障合并青光眼,疗效显著,不良反应发生率低,值得加以推广并应用。     

超声乳化白内障手术后患者角膜内皮细胞损伤的研究

目的:探讨超声乳化白内障手术患者角膜内皮细胞的损伤情况。方法:收集我院确诊为白内障的患者121例,随机分配为微切口组与常规切口组。常规切口组采用3.0 mm切口超声乳化白内障手术方案,微切口组采用1.8 mm小切口超声乳化白内障手术。手术前、手术后1日、7日、1个月、3个月监测患者角膜内皮细胞密度、六角形细胞比例、角膜内皮细胞变异系数及中央角膜厚度。结果:与治疗前相比,两组患者手术后1日、7日、1个月、3个月的角膜内皮细胞密度、六角形细胞比例及角膜内皮细胞变异系数均较治疗前显著降低(P0.05);手术后1日、7日时,两组患者的中央角膜厚度均较手术前明显变薄,有统计学差异(P0.05);手术后1个月、3个月,两组患者的中央角膜厚度均呈降低趋势,最终与手术前相似。微切口组患者不同时点六角形细胞比例与同期常规切口组比较均显著升高,角膜内皮细胞变异系数与同期常规切口组比较均明显降低有统计学差异(P0.05)。两组患者手术前后不同时间点角膜内皮细胞密度、中央角膜厚度组间比较均无统计学差异(P0.05)。结论:超声乳化白内障手术后患者角膜内皮细胞损伤与手术切口有相关性,缩小手术面积的小切口手术使术后修复增快,安全有效,适宜临床推广。     

糖尿病白内障术后黄斑水肿与房水细胞因子的关系

为了探讨2型糖尿病白内障术后黄斑水肿与房水中细胞因子的关系,本研究选取2016年2月至2017年7月在我院治疗的2型糖尿病白内障患者117例117眼,均行超声乳化白内障摘除术,观察术后4周黄斑水肿发生情况以及房水中多种细胞因子水平。研究结果显示:术后4周,有37眼发生黄斑水肿(观察组),未发生黄斑水肿80眼(对照组);观察组术后4周黄斑区视网膜厚度为(247.28±18.37)μm,明显高于对照组(p<0.05),且明显高于术前水平(p<0.05);观察组术后4周干扰素诱导蛋白-10 (IP-10)、巨噬细胞趋化蛋白(MCP-1)、血管内皮生长因子(VEGF)和细胞因子转化生长因子-β2 (TGF-β2)水平分别为(6.01±0.89) pg/mL、(340.03±45.39) pg/mL、(812.28±40.06) pg/mL和(40.05±10.03) pg/mL,明显高于对照组(p<0.05),且高于术前水平(p<0.05);观察组和对照组手术前后粒细胞-巨噬细胞集落刺激因子(GM-CSF)和碱性成纤维细胞生长因子(b-FGF)比较差异无统计学意义(p>0.05);术后4周IP-10、MCP-1、VEGF和TGF-β2水平与黄斑区视网膜厚度呈正相关(r=0.452, 0.501, 0.466和0.470, p<0.05)。本研究的结果初步说明,房水中IP-10、MCP-1、VEGF和TGF-2水平与2型糖尿病白内障术后黄斑水肿有一定关系,有可能成为黄斑水肿的特异性评价指标,值得进一步研究。     

黑龙江省南部农村白内障术后视力的调查

目的:调查白内障的手术情况并评估其手术疗效。方法:采用整群随机抽样方法将黑龙江省南部农村人口按一定的标准划分成抽样单位,两组人员通过预实验统一标准后对年龄(?)50岁共5058人(受检率91%)进行视力和眼部检查,先后在其中的两个抽样单位进行一致性检验。结果:高年龄组、女性和低教育程度者的白内障患病率较高。在所有调查的68只白内障手术眼,最佳矫正视力(?)20/60的占51.5%(35/68)。结论:白内障是50及50岁以上农村人口的主要致盲眼病,迫切需要提高手术质量是关键,特别是高龄和女性患者。     

老年性白内障患者生活质量调查及与自我效能感、自我感受负担和社会关系质量的相关性研究

目的:研究老年性白内障患者生活质量与自我效能感、自我感受负担和社会关系质量的相关性。方法:纳入我院于2018年8月~2020年12月期间接收的老年性白内障患者116例作为研究组,另选取同期来我院检查眼睛视力的100例志愿者作为对照组,两组均填写中文版低视力者生活质量量表(CLVQOL)、自我感受负担量表(SPBS)、一般自我效能感量表(GSES)、社会关系质量量表等评分量表。经Pearson线性相关分析CLVQOL评分与SPBS、GSES和社会关系质量的关系。结果:共发放问卷216份,收回有效问卷212份,回收率为98.15%。研究组的身体机能、精神心理、症状与视功能、社会活动、总分低于对照组,组间对比差异有统计学意义(P<0.05)。研究组身体因素、情感因素、经济因素、总分高于对照组(P<0.05)。研究组个体对环境挑战的认知、个体对自我的认知、个体对控制感的认知以及总分低于对照组(P<0.05)。研究组家庭承担、家庭亲密度、朋友关系、总分低于对照组(P<0.05)。Pearson线性相关分析结果显示,CLVQOL评分与GSES和社会关系质量呈正相关,而与SPBS呈负相关(P<0.05)。结论:老年性白内障患者生活质量较差,与自我效能感、自我感受负担和社会关系质量密切相关,应重视上述相关因素的改善,以提高患者生活质量。