| Part One The experiment of protective effect from No.l DR Decoction on the tissue of diabetic rats’retinaObjective:We observed that the occurrence and development of diabetic retinopathy has a close relationship with diabetes mellitus(DM). Therefore, on the basis of experimental diabetic rats’ model, we wanted to study the influence of NDD on the diabetic rats’ retina tissue and expression of lial cell line derived neurotropic factor(GDNF) and CD68+, then to investigate the protective effect of NDD on the diabetic retinopathy(DR).Methods:25 male SD rats were randomly divided into 4 groups:normal group (6 rats), model group (7 rats), treatment group(6 rats) and control group(6 rats). The rats were injected STZ (60mg/kg) intraperitoneally and after 72 hours those with a blood glucose level higher than or equal to 16.7mmol/L with 3 consecutive days are DM model rats. Rats in treatment group were with NDD (10g/kg) and control group were with DouBeiSi (250mg/kg) each day. Blood glucose level and body weights were measured per 2 weeks. Experiment lasts for 300 days.10% chloral hydrate anesthesia executed rats. The eyeballs were removed and retina slides were made. Retina structure was observed by optical microscope and electron microscopy. Immunohistochemistry assay (Envision method) was used to measure the expression level of GDNF and CD68+, and quantitative analysis.Results:(1) There is no significant difference in glucose between different group before building DM model (P>0.05) and glucose of diabetic rats were markedly higher than normal group after building DM model (P<0.01). (2) There is no significant difference in weight between different group before building DM model (P>0.05) and weight of diabetic rats were significantly lower than normal group after 6 weeks of building DM model (P<0.01). (3) Retinal morphology observation:By light microscope, compared with normal group rats, model group rats retinal disordered arrangement of each layer, and the edema of retinal, RNFL thickness became thicker; the retinal ganglion cells, decreased in number, turned up nucleus pycnosis, chromatin margination became obviously, part of retinal ganglion cells necrosis, nuclear dissolution are visible. Obvious edema in Inner cluster, the inner layer of the core layer was disordered, loose, and vacuole like degeneration, the outer layer of the core layer was disordered and loose. The photoreceptor cells were in a filamentous arrangement, and were still in order, the vacuole-like changes indicated. Compared with model group and control group rats, the treatment group rats retinal layers were arranged in order, and edema of RNFL was not obvious, nucleus pycnosis turned up in few of retinal ganglion cells, accidental vacuole like degeneration. The inner cluster was close to put in order, the photoreceptor cells were less vacuole-like changes of outer segments. By electron microscope, compared with normal group rats, model group rats retinal intercellular spaces of retinal ganglion cells dilatation, nucleus pycnosis was evident, chromatin margination dimly discernible. Small excitation proliferation glial cells surrounded retinal ganglion cells. The outer layer of the core layer was disordered and loose, the nuclear membrane shrinking and invaginating, also showed chromatin margination and small glial cells. The rod outer segments (ROS) of photoreceptors were disordered and loose, breaking and dissolving. Mitochondria swelled and obviously vacuolation. Compared with model group and control group rats, the treatment group rats intercellular spaces of retinal ganglion cells dilatation but in good order, nucleus pycnosis and chromatin margination and small glial cells showed up. The outer layer of the core layer was close to put in order, the electron density in nucleus were homogeneous. The rod outer segments (ROS) of photoreceptors were ranged and focal loose. Mitochondria swelled and vacuolation were hard to find. (4) Compared with normal group, the expression of CD86 in retina, in model group, treatment group and control group was increased significantly (P<0.05). Compared with model group, the expression in treatment group and control group was enhanced (P<0.05). Compared with control group, the expression in treatment group had no significant difference (P>0.05). (5) Compared with normal group, the expression of GDNF in retina, in model group and treatment group and control group was increased significantly (P<0.05). Compared with treatment group and control group, the expression in model group was creased (P<0.05).Conclusions1 There is obvious pathological damage of retina in experimental diabetic rats.2 NND has protective effect on the retina tissue of diabetic rats.3 NND can enhance the expression of GDNF and decrease the expression of CD68, and then reduce the damage and promote the regeneration of axon.Part Two Clinical observation of acupuncture treatment for compression injury of optic nerve atrophyObjective:To observe the clinical efficacy of acupuncture on compression injury of optic nerve atrophy.Methods:68 eyes (45 cases) with compression injury of optic nerve atrophy had been treated by acupuncture. The best corrected visual acuity, visual field and visual evoked potential (VEP) were compared before and after treatment.Result:(1) After 1,3 and 6 months of treatment, the total effective rates of visual acuity improvement were 32.35%,48.43% and 61.29% respectively. (2) After 1,3 and 6 months of treatment, the decreased mean defect (MD) and increased mean light sensitivity (MS) of visual field were both statistically significant (P<0.01). (3) When compared with the situation before treatment, the average latency of the VEP-P100 wave was reduced and the average amplitude was improved significantly (P<0.05).Conclusions:The acupuncture treatment could obviously improve the visual acuity, the visual field and the latency of VEP in compression injury of optic nerve atrophy patients and prevent the aggravation of optic atrophy. |
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