| Objective:To analyze the expression of M-cadherin and Ciliary neurotrophic factor(CNTF)in the medial rectus of concomitant exotropia and to analyze the correlation among myocytes 、 muscle satellite cells(MSC)、 M-cadherin and CNTF.Explore the pathogenesis of concomitant exotropia from the perspective of M-cadherin and CNTF,and put forward new opinions for the treatment and prevention of concomitant exotropia.Method:From April 2019 to January 2020,42 patients with concomitant exotropia in the Tianjin Eye Hospital were selected for surgery.42 patients with medial rectus and 7healthy corneal transplantation donors with medial rectus were used as research object.The 42 patients were divided into four subgroups according to the 15-year expert consensus of Chinese Association of Pediatric Ophthalmology and Strabismus.The medial rectus of 7 healthy corneal transplantation donors was used as control group.The medial rectus in the all groups were made into light microscopic sections and observed.The morphology of the medial rectus、the number of muscle cells and MSC were analyzed.On this basis,the positive expression of M-cadherin and CNTF was detected by immunohistochemical experiments.By comparing the number of MSC,the expression of M-cadherin and CNTF in the rectus muscle of each research object,the expression characteristics of M-cadherin and CNTF in the medial rectus of patients with concomitant exotropia were analyzed.The correlation among M-cadherin and CNTF was analyzed to explore the correlation between myatrophy and CNTF.In the study,spss24.0 software was used for statistical processing,with P < 0.05 as the difference.The optical density of M-cadherin and CNTF was measured by the image-proplus 5.0 medical image software,and the average value was calculated.Pearson’s bivariate analysis was used to describe the relationship between M-cadherin and myocytes、 M-cadherin and CNTF.Result:(1)Under the light microscope,the muscle cells in the control group werearranged orderly,uniform and compact,and fibromuscular stroma was rarely seen.In the study group,the muscle cells were arranged disorderly,with different shapes and looseness.There were more myofibrillar interstitial components and collagen increased significantly.(2)There were 181.57 ± 10.35 muscle fibers in the control group.The number of muscle cells in each subgroup of the study group was less than that of the control group.The constant exotropia subgroup was less than that of the intermittent exotropia group,and the differences were statistically significant(P <0.05).(3)Independent sample T test results show that the average optical density of M-cadherin and CNTF in the medial rectus of the research group were less than those in the control group,and the difference was statistically significant(p<0.05).The average optical density of M-cadherin and CNTF in the rectus muscle of children with constant exotropia were less than those of children with intermittent exotropia,and the difference was statistically significant(p < 0.05).The average optical density of M-cadherin and CNTF of adult group with constant exotropia was less than that of adult group with intermittent exotropia,and the difference was statistically significant(p < 0.05).(4)Pearson bivariate analysis showed that M-cadherin positivity was positively correlated with the number of muscle cells(P<0.05),and M-cadherin positivity was positively correlated with CNTF expression(P < 0.05).Conclusion:The positive expression rate of M-cadherin and CNTF in the medial rectus of concomitant exotropia were lower than the normal level.M-cadherin positivity in the medial rectus of concomitant exotropia was positively correlated with the number of myocytes,and the expression of CNTF was positively correlated with M-cadherin.Therefore,it can be concluded that the medial rectus resection and denervation in concomitant exotropia are closely related,which may be jointly involved in the occurrence and development of concomitant exotropia. |
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