| Background and objectionObstructive lacrimal diseases are common eye diseases with particularly high incidence(5 -7% ) in northeastern area. Such symptoms as lacrimation and pyorrhea bring great sufferings to patients to and, as potential focuses of infection, easily cause corneal ulcer, infection after injury and threaten internal eye operation, even lead to blindness. Conventional operation can cause great damage with much bleeding and is complicated in processure, and scars may be left on face after the operation. Conservative therapy can only act as mechanical dilation temporarily, easily leading to stricture or obstruction once again, with high reoccurrence, which can not be accented by patients.The problem of treating lacrimal obstruction lies in its long narrow tortuous structure, which can easily form stricture or obstruction from damages of local epithelium mucosae and proliferation of granulation tissues by foreign objects and inflammatory stimulation.Therefore, how to inhibit restricture or re - obstruction of lacrimal passage after treatment and keep the lumen area big enough is the new research subject in this field. Nowadays, the research on treating lacrimal obstruction at home and abroad focuses mianly on the comparison of therapeutic effects between various treating methods, which is lack of scientific theoretical background. The experimental researches abroad on re - stricture of vascular and biliary tract systems have reached molecular gene level, such as high expression of PCNA in the course of restricture, activation of ERK1/ERK2 concerning cell death, the dynamic balanced of ECM under the regulation of MMP3/TIMP3 and comparison of differences between various therapeutic methods in relative index before and after treatment; while there have been no systematic and deepgoing reports onpathological process of experimental animal models, mechanism of stricture or obstruction and molecular biological research for various obstructive lacrimal diseases. Thus, this research is designed to study pathological process of lacrimal stricture or obstruction and the differences between related molecular biological indexes before and after treating by Nd; YAG laser and MMC.Experimental Method一. The setup of experimental animal model:1. Experimental animals and their grouping: 40 male Japanese white rabbits (2-3 kg; 6-8 months) were adaptively fed for one week and divided randomly into 2 groups: (1) 30 to lacrimal obstruction group. (2)10 to control group.2. The set up of lacrimal obstruction model: We applied general anesthesia to the rabbits of group one, inserted a balloon stent (2. 0 mm in diameter) to nasolacrimal ducts of both eyes and marked the length, filled the balloon stent with pressure gage to 6 - 8 atmos when pulling it back there was resistance, massaged the lacrimal membrane and marked its length, then withdraw the pressure for one minute, repeated such procedures three times and pulled out the stent, inserted lacrimal probe to nasolacrimal ducts, infused angiosclerotic agent ( gel sponge + iodine) , and pulled out the prob. The rabbits were fed till the appearance of the symptoms such as lacrimation and pyorrhea. Altogether 30 models of lacrimal obstruction were successfully set up.二. Treatment of lacrimal obstruction models by Nd: YAG laser and HMC: The models were divided into two group (1)lacrimal plastic operation with laser (Y) ; (2)lacrimal plastic operation with laser plus MMC treatment ( Y + M) , 15 rabbits for each group treated with different methods respectively. The rabbits were killed after three month feeding.三. Sample observation and detection of molecular biological indexes.1. pathological examination:After setting up the models of the two groups, the rabbits of groups Y and Y+ M were killed after treated three months. And the lacrimal sample was takenand cut into three sections, examined under the light and electronic microscopesrespectively and measured immunohistochemically.2. Immunohistochemical analy... |
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