Assessing base-resolution DNA mechanics on the genome scale.

Intrinsic DNA properties including bending play a crucial role in diverse biological systems. A recent advance in a high-throughput technology called loop-seq makes it possible to determine the bendability of hundred thousand 50-bp DNA duplexes in one experiment. However, it's still challenging to assess base-resolution sequence bendability in large genomes such as human, which requires thousands of such experiments. Here, we introduce 'BendNet'-a deep neural network to predict the intrinsic DNA bending at base-resolution by using loop-seq results in yeast as training data. BendNet can predict the DNA bendability of any given sequence from different species with high accuracy. To explore the utility of BendNet, we applied it to the human genome and observed DNA bendability is associated with chromatin features and disease risk regions involving transcription/enhancer regulation, DNA replication, transcription factor binding and extrachromosomal circular DNA generation. These findings expand our understanding on DNA mechanics and its association with transcription regulation in mammals. Lastly, we built a comprehensive resource of genomic DNA bendability profiles for 307 species by applying BendNet, and provided an online tool to assess the bendability of user-specified DNA sequences (http://www.dnabendnet.com/).

Extraradical Mycorrhizal Hyphae Promote Soil Carbon Sequestration through Difficultly Extractable Glomalin-Related Soil Protein in Response to Soil Water Stress.

Soil water stress (WS) affects the decomposition of soil organic carbon (SOC) and carbon (C) emissions. Glomalin, released by arbuscular mycorrhizal fungi into soil that has been defined as glomalin-related soil protein (GRSP), is an important pool of SOC, with hydrophobic characteristics. We hypothesized that mycorrhizal fungi have a positive effect on SOC pools under soil WS for C sequestration in GRSP secreted by extraradical mycorrhizal hyphae. A microsystem was used to establish a root chamber (co-existence of roots and extraradical mycorrhizal hyphae) and a hyphal chamber (the presence of extraradical mycorrhizal hyphae) to study changes in plant growth, leaf water potential, soil aggregate stability, SOC, GRSP, C concentrations in GRSP (CGRSP), and the contribution of CGRSP to SOC after inoculating Rhizophagus intraradices with trifoliate orange (Poncirus trifoliata) in the root chamber under adequate water (AW) and WS. Inoculation with R. intraradices alleviated negative effects on leaf water potential and plant growth after 7 weeks of WS. Soil WS decreased SOC and mean weight diameter (MWD), while AMF inoculation led to an increase in SOC and MWD in both chambers, with the most prominent increase in the hyphal chamber under WS. The C concentration in easily extractable GRSP (EE-GRSP) and difficultly extractable GRSP (DE-GRSP) was 7.32 - 12.57 and 24.90 - 32.60 mg C/g GRSP, respectively. WS reduced CGRSP, while AMF mitigated the reduction. Extraradical mycorrhizal hyphae increased GRSP production and CGRSP, along with a more prominent increase in DE-GRSP under WS than under AW. Extraradical mycorrhizal hyphae increased the contribution of CDE-GRSP to SOC only under WS. CEE-GRSP and CDE-GRSP were significantly positively correlated with SOC and MWD. It is concluded that extraradical mycorrhizal hyphae prominently promoted C sequestration of recalcitrant DE-GRSP under soil WS, thus contributing more organic C accumulation and preservation in aggregates and soil C pool.

A case report and review of lymphocutaneous nocardiosis caused by Nocardia brasiliensis reported in China.

Primary cutaneous nocardiosis caused by Nocardia brasiliensis is an uncommon disease. The present authors report a Chinese woman presented with lymphocutaneous nocardiosis caused by N. brasiliensis. The lesion begin with her right hand after an unknown insect sting and evolved rapidly and formed painful erythema and two subcutaneous nodules and abscesses on her right forearm in 5 days. N. brasiliensis was isolated from pustule and identified by gene sequencing. The patient received 2 weeks of combination therapy contained infusion of amoxilin potassioum clavinet and oral TMP/SMX and followed by a single therapy of oral TMP/SMX for 1 month and got a marked improvement. The present authors reviewed a case of lymphocutaneous nocardiosis caused by N. brasiliensis reported in China.

Carboxymethyl chitosan nanoparticles coupled with CD59-specific ligand peptide for targeted delivery of C-phycocyanin to HeLa cells.

The combination of nanotechnology and medicine will be the next generation of vehicles for targeted drug delivery. Carboxymethyl chitosan loaded with the anticancer drug C-phycocyanin and the CD59-specific ligand peptide for cancer cell targeting were used to create C-phycocyanin/carboxymethyl chitosan-CD59-specific ligand peptide nanoparticles using the ionic-gelation method. Optimal synthesis conditions, selected by response surface methodology, comprised the ratio carboxymethyl chitosan:C-phycocyanin = 3:1, and carboxymethyl chitosan and CaCl2 concentrations of 2.0 and 1.0 mg/mL, respectively. The resulting nanoparticles were spherical, with diameters of approximately 200 nm; the entrapment efficient was about 65%; and the drug loading was about 20%. The release of C-phycocyanin from C-phycocyanin/carboxymethyl chitosan nanoparticles was pH sensitive and had a sustainable effect in vitro. Guided by the CD59-specific ligand peptide, the nanoparticles efficiently targeted the surface of HeLa cells and had an obvious inhibitory effect on HeLa cell proliferation as determined by methyl thiazolyl tetrazolium assays. The nanoparticles were hemocompatible and induced apoptosis by upregulation of cleaved caspase-3 and cleaved polyADP-ribose polymerase proteins, and downregulation of Bcl-2 proteins. Our study provides a novel approach to the research and development of marine drugs, and support for targeted therapy using anticancer drugs.

Molecular targets and mechanisms of Jiawei Jiaotai Pill on diabetic cardiomyopathy based on network pharmacology.

BACKGROUND: Jiawei Jiaotai Pill is commonly used in clinical practice to reduce apoptosis, increase insulin secretion, and improve blood glucose tolerance. However, its mechanism of action in the treatment of diabetic cardiomyopathy (DCM) remains unclear, hindering research efforts aimed at developing drugs specifically for the treatment of DCM. AIM: To explore the pharmacodynamic basis and molecular mechanism of Jiawei Jiaotai Pill in DCM treatment. METHODS: We explored various databases and software, including the Traditional Chinese Medicine Systems Pharmacology Database, Uniport, PubChem, GenCards, String, and Cytoscape, to identify the active components and targets of Jiawei Jiaotai Pill, and the disease targets in DCM. Protein-protein interaction network, gene ontology, and Kyoto Encyclopedia of Genes and Genomes analyses were used to determine the mechanism of action of Jiawei Jiaotai Pill in treating DCM. Molecular docking of key active components and core targets was verified using AutoDock software. RESULTS: Total 42 active ingredients and 142 potential targets of Jiawei Jiaotai Pill were identified. There were 100 common targets between the DCM and Jiawei Jiaotai Pills. Through this screening process, TNF, IL6, TP53, EGFR, INS, and other important targets were identified. These targets are mainly involved in the positive regulation of the mitogen-activated protein kinase (MAPK) MAPK cascade, response to xenobiotic stimuli, response to hypoxia, positive regulation of gene expression, positive regulation of cell proliferation, negative regulation of the apoptotic process, and other biological processes. It was mainly enriched in the AGE-RAGE signaling pathway in diabetic complications, DCM, PI3K-Akt, interleukin-17, and MAPK signaling pathways. Molecular docking results showed that Jiawei Jiaotai Pill's active ingredients had good docking activity with DCM's core target. CONCLUSION: The active components of Jiawei Jiaotai Pill may play a role in the treatment of DCM by reducing oxidative stress, cardiomyocyte apoptosis and fibrosis, and maintaining metabolic homeostasis.

[Comparison of long-term clinical outcomes between descemet's stripping endothelial keratoplasty and deep lamellar endothelial keratoplasty].

OBJECTIVE: To investigate the differences of long-term clinical outcomes between two kinds of corneal endothelial keratoplasty (EK): DSEK and DLEK. METHODS: Retrospective, comparative, clinical case series study. Twenty-six patients (26 eyes), undergoing DLEK and thirty-six patients (36 eyes), undergoing DSEK during the period of October 2005 to March 2008, were involved in this study. Before and at 6 month intervals after surgery, patients' data were collected to analyze the surgery success rate, graft dislocation rate, best corrected visual acuity (BSCVA), graft survival rate and endothelial cell density (ECD). The follow-up time was 3 to 5 years. RESULTS: The success rate of DLEK was 88.5% while DSEK was 86.1%. Average BSCVA of DLEK were similar to those of DSEK at each follow-up time after 12 months postoperatively. Graft survival rates of DLEK and DSEK were respectively 87% and 75.9%, where as ECD were respectively 1638 cells/mm(2) and 1874 cells/mm(2) at 36 month postoperatively, the data were similar in both ECD and graft survival rate between DLEK and DSEK at 60 months postoperatively. CONCLUSIONS: The success rate and long-term visual outcomes of DLEK were similar with those of DSEK. To obtain objective results, it is better to consider both ECD and graft survival rate instead of recording ECD only for its localization in evaluating the efficacy of EK.

Comparing the precision of the pSOFA and SIRS scores in predicting sepsis-related deaths among hospitalized children: a multi-center retrospective cohort study.

BACKGROUND: The latest sepsis definition includes both infection and organ failure, as evidenced by the sequential organ failure assessment (SOFA) score. However, the applicability of the pediatric SOFA score (pSOFA) is not yet determined. This study evaluated the effectiveness of both pSOFA and system inflammatory reaction syndrome (SIRS) scores in predicting sepsis-related pediatric deaths. METHODS: This is a retrospective multi-center cohort study including hospitalized patients <18 years old with diagnosed or not-yet-diagnosed infections. Multivariate analyses were carried out to evaluate risk factors for in-hospital mortality. According to Youden index (YI), three sub-categories of pSOFA were screened out and a new simplified pSOFA score (spSOFA) was formed. The effectiveness and accuracy of prediction of pSOFA, SIRS and spSOFA was retrieved from the area under the receiver operating characteristic curve (AUROC) and Delong's test. RESULTS: A total of 1,092 participants were eligible for this study, and carried a 23.4% in-hospital mortality rate. The 24-h elevated pSOFA score (24 h-pSOFA), bloodstream infection, and mechanical ventilation (MV) requirement were major risk factors associated with sepsis-related deaths. The AUROC analysis confirmed that the spSOFA provided good predictive capability in sepsis-related pediatric deaths, relative to the 24 h-pSOFA and SIRS. CONCLUSIONS: The pSOFA score performed better than SIRS in diagnosing infected children with high mortality risk. However, it is both costly and cumbersome. We, therefore, proposed spSOFA to accurately predict patient outcome, without the disadvantages. Nevertheless, additional investigations, involving a large sample population, are warranted to confirm the conclusion of this study.

[Limbal allografting from related live donors for limbal stem cell deficiency secondary to ocular chemical burn].

OBJECTIVE: To investigate the efficacy and complications of limbal allografting from related live donors (RL-LAT) for limbal stem cell deficiency secondary to ocular chemical burn. METHODS: Retrospective comparative case series. Limbal allografting from related live human leukocyte antigen (HLA)-matched (n = 10) and-unmatched donors (n = 2) was performed in 12 consecutive patients (12 eyes) with limbal stem cell deficiency secondary to ocular chemical burn, including 9 alkali burn and 3 acid burn; whereas allolimbal cadaver transplant was performed in another 15 patients in Zhongshan Ophthalmic Center between April 2006 to December 2007. Systemic cyclosporine A was administered to later eight recipients in living related donor group and all patients in cadaver donor group. Main outcome measures were restoration of corneal epithelium, reduction in corneal vascularization, improved corneal clarity, and visual improvement. Mean follow-up was (11.4 ± 3.6) months (from 12 to 27). RESULTS: In living related donor group, ten patients (83.3%) achieved initially reepithelialize, and epithelial healing time was (9.6 ± 3.4) d. Nine patients (75.0%) achieved stable ocular surface (stable corneal epithelium, decreased vascularization of corneal surface, and reduced corneal opacification). However, in seven eyes (77.8%) achieved stable ocular surface, gradual recurrence of peripheral corneal vascularization occurred after 5 to 8 months postoperatively. Whereas in cadaver donor group, twelve patients (80.0%) achieved initially reepithelialize, and epithelial healing time was (11.2 ± 4.6) d. Seven patients (46.7%) achieved stable ocular surface. However, in all seven eyes achieved stable ocular surface, gradual recurrence of peripheral corneal vascularization occurred after 4 to 10 months postoperatively. The differences of both the rate of initially reepithelialize and epithelial healing time between these two groups showed no statistical significance (χ(2) = 1.764, P = 0.117; t = 0.116, P = 0.133, respectively). However, the differences of both the successful rate of ocular surface reconstruction and the recurrent rate of corneal vascularization during the follow-up period between these two groups were statistically significant (χ(2) = 4.158, P = 0.015; χ(2) = 3.463, P = 0.022, respectively). In living related donor group, features of graft rejection developed in two patients with postoperative stable ocular surface, Both rejected recipients had one among HLA-matched and one among-unmatched respectively. Whereas in cadaver donor group, features of graft rejection developed in three patients with postoperative stable ocular surface. None of the donor eyes had any complications. CONCLUSIONS: Limbal allografting from related live donors is more effective to reconstruct the ocular surface of limbal stem cell deficiency secondary to ocular chemical burn than allolimbal cadaver transplant. HLA-matched limbal allografting could reduce postoperative graft rejection and systemic cyclosporine A is useful in ensuring long-term survival.

[Effect of temporary anchor sutures on Descemet stripping endothelial keratoplasty in aphakic eyes].

OBJECTIVE: To investigate the feasibility, efficacy, and complications of the temporary anchor sutures for endothelial graft fixation in Descemet stripping endothelial keratoplasty (DSEK) in aphakic eyes. METHODS: Non-randomized retrospective case series. Twelve consecutive cases (12 eyes) with aphakic bullous keratopathy underwent DSEK using the temporary anchor sutures technique for fixation of donor button in Zhongshan Ophthalmic Center between April to December in 2007. All cases were resulted from lens extraction and best spectacle-corrected visual acuity (BSCVA) was inferior or equal to 0.04. Eight cases were with preoperative pain. Prospective data of BSCVA, corneal astigmatism, curvature and thickness were collected on all 12 eyes preoperatively and at 3, 6 and 12 months postoperatively. Average endothelial cell density (ECD) and endothelial cell loss (ECL) were recorded at 6 and 12 months postoperatively. The follow-up period was 12 to 20 months. RESULTS: All cases were performed DSEK successfully using the temporary anchor sutures and the grafts were well-attached without dislocation. On postoperative day 1, papillary block glaucoma occurred in 2 eyes and mannitol 20% was administered intravenously. The intraocular pressure in the 2 eyes returned to normal due to the air bubble absorption on postoperative day 2. The endothelial grafts showed mild to moderate edema in all eyes and became clear in 8 to 15 days postoperatively. All the corneas were clear during follow-up. In 12 months postoperatively, BSCVA was 0.7 in 16.7% of eyes (n = 2), 0.5 in 25.0% of eyes (n = 3), 0.4 in 33.3% of eyes (n = 4), and 0.3 in 25.0% of eyes (n = 3); mean corneal astigmatism was (2.40 + or - 0.70) diopters, mean corneal curvature was (45.40 + or - 1.50) diopters, and mean corneal thickness was (591.5 + or - 20.4) microm. Mean endothelial cell density (ECD) was (2088 + or - 146) cells/mm(2) [(28.9 + or - 3.9)% endothelial cell loss] and (1857 + or - 101) cells/mm(2) [(36.7 + or - 3.1)% endothelial cell loss] in 6 and 12 months postoperatively, respectively. CONCLUSION: The temporary anchor sutures technique was easy to perform and effectively prevented graft dislocation and detachment into the vitreous cavity.

MiR-143 Regulates Milk Fat Synthesis by Targeting Smad3 in Bovine Mammary Epithelial Cells.

Milk fat is the main nutritional component of milk and is also an important indicator for evaluating milk quality. Substantial evidence has implicated miRNAs in the synthesis of milk fat. miR-143 is one of the miRNAs closely related to lipid metabolism. Herein, miR-143 upregulation remarkably promoted the production of lipid droplets and increased the level of intracellular triglyceride (TAG). Meanwhile, miR-143 suppression overtly repressed TAG synthesis and lipid droplet accumulation in bovine mammary epithelial cells (BMECs). At the same time, miR-143 significantly upregulated the genes associated with lipid synthesis, including PPARγ, SCD1, CEBPß, and SREBP1. To examine the regulatory mechanism of miR-143 in milk fat synthesis, Smad3 was predicted as a new potential miR-143 target gene by TargetScan. Further studies found that miR-143 expression was inversely related to the levels of Smad3 mRNA and protein. Furthermore, luciferase reporter assays confirmed Smad3 to be a miR-143 direct target. Moreover, Smad3 gene silencing significantly increased intracellular TAG level in BMECs. These findings revealed that miR-143 promotes the TAG synthesis in BMECs via increasing the lipid synthesis related gens expression by targeting Smad3. The results of this study can be exploited in devising novel approaches for improving the nutritional value of milk in dairy cows.

[Advances in research on immune mechanism of moxibustion for treating tumor].

Treatment of tumors, especially the malignant tumors, is a world-class medical problem and still plagues clinicians and medical scientists a lot nowadays. Moxibustion therapy has been used in the treatment of tumors in clinic practice for many years and the related mechanism researches have achieved a lot of achievements. In the present paper, we reviewed researches on moxibustion treatment for tumor from the self-regulation of the immune system in patients and animal models. Outcomes display that moxibustion therapy has an action in resisting tumors by 1) regulating innate immune defensive function and enhancing adaptive immunity (by up-regulating activities of natural killer [NK] cells, and phagocytic function of macrophages), 2) stimulating cellular immunity (by increasing the ratio of CD4＋/CD8＋， lymphocyte transformation rate, etc.), and B lymphocyte-mediated humoral immunity (via regulating contents of IgG, IgA, IgM, etc.), 3) modulating levels of cytokines as interleukins, interferons, tumor necrosis factor superfamily colony stimulating factor, chemokine growth factor, vascular endothelial growth factor，VEGF, etc., 4) regulating expression of many related proteins and genes, and 5) regulating related hormones, neurotransmitters, intracellular kinases signaling, etc., and other immune-related components.

[Effect of warm acupuncture at Yifeng (TE 17) on facial paralysis with periauricular pain during pregnancy].

OBJECTIVE: To compare the curative effect between the warm acupuncture at Yifeng (TE 17) combined with conventional acupuncture and TDP plus conventional acupuncture on facial paralysis with periauricular pain during pregnancy. METHODS: A total of 68 patients were randomized into an observation group (36 cases, 3 cases dropped off) and a control group (32 cases, 1 case dropped off). First week, TDP light was used on the affected side in the control group, and warm acupuncture at Yinfeng (TE 17) on the affected side was used in the observation group, both once a day. From the second week, both groups were given acupuncture at Chengjiang (CV 24) and the affected side of Cuanzhu (BL 2), Yangbai (GB 14), Taiyang (EX-HN 5), Yingxiang (LI 20), Dicang (ST 4), etc. and electroacupuncture (continuous wave, 2 Hz in frequency) was connected at Cuanzhu (BL 2) and Taiyang (EX-HN 5), Jiache (ST 6) and Dicang (ST 4). Both treatments were given every other day for 4 weeks totally. The visual analogue scale (VAS) score of the periauricular pain degree before treatment and after 1 week of treatment, the House-Brackmann (H-B) facial nerve function grading scale and facial disability index (FDI) score before treatment and after 2, 4 weeks of treatment were compared between the two groups. RESULTS: After 1 week of treatment, the VAS scores of both groups decreased (P<0.001), and the variation in the observation group was larger than the control group (P<0.01). After 2 and 4 weeks of treatment, the H-B grading of both groups were improved (P<0.01, P<0.05), and those in the observation group were better than the control group (P<0.05). After 2 and 4 weeks of treatment, the FDI physical function (FDIP) scores of both groups were higher (P<0.01), and the FDI social life function (FDIS) scores were lower than before treatment (P<0.05, P<0.01), and the FDIP scores in the observation group were higher than those in the control group (P<0.05). CONCLUSION: Warm acupuncture at Yinfeng (TE 17) combined with conventional acupuncture can effectively improve the periauricular pain and facial nerve function in patients of facial paralysis with periauricular pain during pregnancy, and the curative effect is better than TDP plus conventional acupuncture.

[Preliminary clinical study of Descemet's stripping with endothelial keratoplasty for bullous keratopathy].

OBJECTIVE: To investigate the indications, surgical procedure, clinical efficacy, and the prevention and management of complications of Descemet's stripping with endothelial keratoplasty (DSEK) for bullous keratopathy. METHODS: In the nonrandomized retrospective consecutive case series, 8 patients (8 eyes) with bullous keratopathy at Zhongshan Ophthalmic Center between September 2006 and October 2007 underwent DSEK surgery. During the surgical procedure, the Descemet's membrane and abnormal endothelial layer were stripped from the central recipient posterior surface with 7.75 mm diameter, and then a specially designed scraper was used to roughen the peripheral recipient posterior stroma. Other surgical techniques were the same with routine DSEK surgery. The adherence of the donor lenticule to the recipient posterior stroma and postoperative donor lenticule dislocation were monitored in the early stage after surgery. Best spectacle-corrected visual acuity (BSCVA), graft clearance, corneal astigmatism and endothelial cell density (ECD) were observed over a 3-9 months follow-up period. RESULTS: All donor lenticules were well adherent to the recipient posterior stroma and no graft dislocation occurred postoperatively. One patient had papillary block glaucoma at 1-day, and relieved after 48 hours postoperative. All grafts remained transparent, and had improved visual acuity. BSCVA was 0.3 - 0.7 postoperative. Six patients with preoperative pain had been pain free after DSEK procedure. Mean corneal astigmatism was (1.90 +/- 0.70) diopter (D). Mean ECD was (2014 +/- 192) cells/mm(2). CONCLUSIONS: Compared with deep lamellar endothelial keratoplasty (DLEK), DSEK procedure is technically easier and less traumatic to recipient cornea and anterior chamber structures. The skill of roughening the peripheral recipient posterior stroma should prevent postoperative graft dislocation effectively.

[Clinical observation on time-effect of electroacupuncture for idiopathic facial paralysis].

OBJECTIVE: To observe the effect of different acupuncture frequency and duration of needle retention on idiopathic facial paralysis, and optimize the acupuncture treatment plan. METHODS: A total of 140 patients were randomized into a group A (37 cases, 3 cases dropped off), a group B (35 cases, 3 cases dropped off), a group C (34 cases, 1 case dropped off) and a group D (34 cases, 1 case dropped off). Under the same basic treatment, acupuncture intervention time (day 8 of morbidity), acupoint selection [Cuanzhu (BL 2), Yangbai (GB 14), Taiyang (EX-HN 5), Yingxiang (LI 20), Jiache (ST 6), Dicang (ST 4) on the affected side, Chengjiang (CV 24) and Hegu (LI 4) on the unaffected side] and electroacupuncture intervention, different acupuncture interval time and duration of needle retention were applied. In the group A, the treatment was given 20 min once a day, while the group B 30 min once a day, the group C 20 min once every 2 days, the group D 30 min once every 2 days. Totally 20-day treatment were required. The House-Brackmann (H-B) facial nerve function grading system was used to evaluate the improvement of clinical symptom, the situation and latency periods of the R1 wave in blink reflex and facial nerve motor conduction before and after treatment were observed in the 4 groups. RESULTS: After treatment, the cured rates in the 4 groups were 44.1% (15/34), 46.9% (15/32), 57.6% (19/33) and 51.5% (17/33), there was no significant difference among 4 groups (P>0.05). The situation and latency periods of the R1 wave in blink reflex and latency periods and amplitude of facial nerve motor conduction after treatment were improved in the 4 groups (P<0.01, P<0.05), there was no significant difference among 4 groups (P>0.05). CONCLUSION: Acupuncture 20 min once a day, 30 min once a day, 20 min once every 2 days and 30 min once every 2 days have significant effect on the recovery of idiopathic facial paralysis, and the effect is comparable.

Galectins as potential emerging key targets in different types of leukemia.

Galectins are carbohydrate-binding proteins and these have very high affinity for ß-galactoside containing glycoproteins and glycolipids. Amongst sixteen types of galectin, the role of galectin 1, 3, 9 and 12 is defined in the development and progression of different types of leukemia including acute myeloid leukemia, acute promyelocytic leukemia, B-cell precursor acute lymphoblastic leukemia, adult T cell leukemia and chronic lymphocytic leukemia. There are multiple mechanisms through which these galectins may affect tumor proliferation. These may include increased production of tumor resistance conferring proteins such as multidrug resistance (MDR-1) and myeloid cell leukemia (MCL-1). Moreover, galectin-9 may act on Tim-3 receptors present on the circulating CD8+ T cells to impair immune system function and the latter provide an ideal environment for the proliferation of leukemic cells. The present review describes the role and mechanisms involved in galectin-mediated development and progression of different types of leukemia.

[Deep lamellar endothelial keratoplasty for bullous keratopathy].

OBJECTIVE: To investigate the efficacy, postoperative complications and management of deep lamellar endothelial keratoplasty (DLEK) in complex cases of severe bullous keratopathy. METHODS: In the nonrandomized retrospective consecutive case series, fifteen cases (15 eyes) of severe and complex bullous keratopathy at Zhongshan Ophthalmic Center underwent DLEK in combination with other intraocular surgeries between October 2005 and March 2006. DLEK was combined with vitrectomy and ciliary sulcus sutured intraocular lens implantation in two patients, with vitrectomy and intraocular lens extraction in two patients and with vitrectomy and intraocular lens exchange in one patient Four patients with aphakic eyes underwent subsequent ciliary sulcus sutured intraocular lens implantation within 4 to 6 months after the DLEK donor tissue had been placed. The best spectacle corrected visual acuity (BSCVA), corneal astigmatism, curvature and endothelial cell density (ECD) were examined preoperatively and postoperatively. The graft-host interface was photographed by anterior segment optic coherent tomography (OCT). Repeated Measures Anova was applied for management of the data. RESULTS: On postoperative day 1, 13 grafts were well attached to the host except for one dislocation (re-located immediately and well attached). Fluid leakage between the graft-host interface occurred in one eye (absorbed on day 5). All the grafts remained clear during the follow-up. Five cases (33.3%) showed narrow gaps between the borders of graft and host. Bullous epithelial lesion reoccurred above the gap in two cases (13.3%), and disappeared during follow-up. BSCVA in 4 eyes (26.7%) was 0.4, in 3 eyes (20.0%) was 0.3, in 4 eyes (26.7%) was 0.2, and in 1 eye (6.7%) was 0.1 after DLEK. At 6, 9 and 12 months, the average corneal astigmatism were (2.80 +/- 0.70) D, (2.60 +/- 0.70) D and (2.20 +/- 0.60) D (F = 5.591, P = 0.090), average corneal curvature were (43.60 +/- 1.90) D, (44.10 +/- 1.30)D and (44.10 +/- 1.00) D (F =1.515, P = 0.237). The average central corneal thickness were (666.1 +/- 70.6) microm, (544.5 +/- 30.9) microm, (538.2 +/- 34.7) microm and (532.4 +/- 41.6) microm (F = 32.692, P = 0.000) at preoperatively, 6, 9 and 12 months postoperatively, respectively. The mean ECD was (1915.7 +/- 90.8) cells/mm2 postoperatively. CONCLUSIONS: DLEK surgery is an effective and safe procedure in severe and complex cases of bullous keratopathy,but it has to be successfully combined with other anterior segment surgeries. DLEK graft without sutures can tolerate subsequent other anterior segment surgeries at 4 to 6 months after placement of the donor tissue.

[Lamellar keratoplasty for treatment of peripheral corneal perforation].

OBJECTIVE: To explore the indications, efficacy, and complications of different types of lamellar keratoplasty (LKP) for peripheral corneal perforation. METHODS: In our nonrandomized retrospective case series, 40 cases (42 eyes) with peripheral corneal perforation at Zhongshan Ophthalmic Center between January 2003 and June 2006 underwent semi lunar LKP (14 eyes), crescent LKP (11 eyes), biconvex LKP (7 eyes), ring-shaped LKP (5 eyes), and total LKP (5 eyes). The selection of various procedures was based on the size and shape of corneal ulceration and perforation. Postoperative visual acuity (VA), corneal clarity, astigmatism, and complications were studied during a follow-up of 3 to 21 months. The initial causes and recurrence for peripheral corneal perforation were analyzed. RESULTS: The initial causes of corneal perforation were mostly Terrien's marginal degeneration (35.7%), Mooren's ulcer (31.0%), herpes simplex keratitis (11.9%), chemical/thermal burns (9.5%), and corneal ecstatic diseases (7. 1%). The lamellar graft attached to the host well and was transparent in 34 eyes (81.0%) following LKP. VA less than 0.1 were presented in 13 eyes (31.0%) preoperatively and in 3 eyes (7.1%) postoperatively. VA in 27 eyes (64.3%) improved after LKP, and best-corrected VA in nine eyes (21.4%) was 0.5 or better. The mean corneal astigmatism was (7.23 +/- 1.22) D three months postoperatively, and this decreased to (3.72 +/-1.76) D in six to nine months postoperatively when sutures were removed. The postoperative complications included graft-host interface effusion (8 eyes, 19.1%), secondary glaucoma (8 eyes, 19.1%) and reoccurrence of primary diseases, including Mooren's ulcer (3 eyes, 23. 1%) and herpes simplex keratitis (1 eye, 20.0%). CONCLUSIONS: LKP is effective to restore the integrity of the eyes with peripheral corneal perforation. Choosing the appropriate type of LKP based on different shape of corneal perforations can remove the corneal lesion and spare the normal tissue to the maximum. Moreover, the well-matched graft configuration can reduce the postoperative astigmatism, helping restore or improve the vision in most cases.

Role of glutamine in the mediation of E-cadherin, p120-catenin and inflammation in ventilator-induced lung injury.

BACKGROUND: Ventilator-induced lung injury (VILI) is commonly associated with barrier dysfunction and inflammation reaction. Glutamine could ameliorate VILI, but its role has not been fully elucidated. This study examined the relationship between inflammatory cytokines (interleukin [IL]-6, tumor necrosis factor [TNF]-α, and IL-10) and adherens junctions (E-cadherin, p120-catenin), which were ameliorated by glutamine in VILI, both in vitro and in vivo. METHODS: For the in vivo study, 30 healthy C57BL/6 mice weighing 25-30 g were randomly divided into five groups with random number table (n = 6 in each group): control (Group C); low tidal volume (Group L); low tidal volume + glutamine (Group L + G); high tidal volume (Group H); and high tidal volume + glutamine (Group H + G). Mice in all groups, except Group C, underwent mechanical ventilation for 4 h. For the in vitro study, mouse lung epithelial 12 (MLE-12) cells pretreated with glutamine underwent cyclic stretching at 20% for 4 h. Cell lysate and lung tissue were obtained to detect the junction proteins, inflammatory cytokines, and lung pathological changes by the Western blotting, cytokine assay, hematoxylin and eosin staining, and immunofluorescence. RESULTS: In vivo, compared with Group C, total cell counts (t = -28.182, P < 0.01), the percentage of neutrophils (t = -28.095, P < 0.01), IL-6 (t = -28.296, P < 0.01), and TNF-α (t = -19.812, P < 0.01) in bronchoalveolar lavage (BAL) fluid, lung injury scores (t = -6.708, P < 0.01), and the wet-to-dry ratio (t = -15.595, P < 0.01) were increased in Group H; IL-10 in BAL fluid (t = 9.093, P < 0.01) and the expression of E-cadherin (t = 10.044, P < 0.01) and p120-catenin (t = 13.218, P < 0.01) were decreased in Group H. Compared with Group H, total cell counts (t = 14.844, P < 0.01), the percentage of neutrophils (t = 18.077, P < 0.01), IL-6 (t = 18.007, P < 0.01), and TNF-α (t = 10.171, P < 0.01) in BAL fluid were decreased in Group H + G; IL-10 in BAL fluid (t = -7.531, P < 0.01) and the expression of E-cadherin (t = -14.814, P < 0.01) and p120-catenin (t = -9.114, P < 0.01) were increased in Group H + G. In vitro, compared with the nonstretching group, the levels of IL-6 (t = -21.111, P < 0.01) and TNF-α (t = -15.270, P < 0.01) were increased in the 20% cyclic stretching group; the levels of IL-10 (t = 5.450, P < 0.01) and the expression of E-cadherin (t = 17.736, P < 0.01) and p120-catenin (t = 16.136, P < 0.01) were decreased in the 20% cyclic stretching group. Compared with the stretching group, the levels of IL-6 (t = 11.818, P < 0.01) and TNF-α (t = 8.631, P < 0.01) decreased in the glutamine group; the levels of IL-10 (t = -3.203, P < 0.05) and the expression of E-cadherin (t = -13.567, P < 0.01) and p120-catenin (t = -10.013, P < 0.01) were increased in the glutamine group. CONCLUSIONS: High tidal volume mechanical ventilation and 20% cyclic stretching could cause VILI. Glutamine regulates VILI by improving cytokines and increasing the adherens junctions, protein E-cadherin and p120-catenin, to enhance the epithelial barrier function.

[Effect of endocyclophotocoagulation on survival of corneal grafts].

OBJECTIVE: To observe the effect of semiconductor (diode) laser endocyclic-photocoagulation (ECP) on the survival of corneal grafts for patients with uncontrolled refractory glaucoma secondary to penetrating keratoplasty (PKP). METHODS: Thirty-four eyes of 34 patients with refractory glaucoma were prospectively assigned to diode laser ECP in 12 eyes, and diode laser ECP with anterior vitrectomy in 22 eyes in Zhongshan Ophthalmic Center from March 2000 to April 2004 as ECP group. Twenty-six eyes of 26 patients were underwent trans-scleral cyclophotocoagulation (TCP) as TCP group. The preoperative and postoperative follow-up parameters evaluated included visual acuity (VA), intraocular pressure (IOP), corneal graft clearance, endothelial cell density (ECD), anterior chamber inflammation, ciliary processes and chamber angle (viewed under ultrasonic biomicroscope, UBM), and the postoperative complications were recorded as well. RESULTS: In ECP group, a mean of (2.7 +/- 1.3) glaucoma medications was used with mean preoperative IOP value of (40.1 +/- 9.6) mm Hg preoperatively. IOP was decreased (below 21 mm Hg) in 13 eyes (38.2%) 3 months postoperatively. Six months after ECP, decreased IOP (below 21 mm Hg) was obtained in 23 eyes (67.7%). In TCP group, a mean of (2.3 +/- 1.5) glaucoma medications were administrated with mean preoperative IOP value of (41.4 +/- 10.4) mm Hg preoperatively. IOP was decreased (below 21 mm Hg) in 10 eyes (38.5%) 3 months postoperatively. Six months after TCP, decreased IOP (below 21 mm Hg) was obtained in 8 eyes (30.8%). The difference of IOP reduction between these two groups showed no statistical significance 3 months postoperatively (chi(2) = 0.0003, P = 0.986), but it was statistically significant after 6 months (chi(2) = 8.024, P = 0.005). In ECP group, 25 eyes had clear corneal grafts preoperatively, with mean ECD of (1353 +/- 293) cells/mm(2). Postoperative mean ECD was (1013 +/- 170) cells/mm(2). In TCP group, 20 eyes had clear corneal grafts preoperatively, with mean ECD of (1221 +/- 191) cells/mm(2). Postoperative mean ECD was (847 +/- 136) cells/mm(2). The difference of ECD between ECP and TCP group was statistically significant (t = -0.009, P = 0.033). Reactive no-specific inflammation in anterior chamber occurred in 9 eyes (26.5%) in ECP group and 21 eyes (80.8%) in TCP group, which showed statistical significance (chi(2) = 17.376, P = 0.001). CONCLUSIONS: ECP proved more efficacious than TCP in controlling IOP in patients with post-penetrating keratoplasty glaucoma in long-term observation. Compared with TCP, ECP shows less corneal graft endothelial cell loss, and comparatively mild post-ECP uveitis, which improves the survival of corneal grafts greatly.

[Preliminary clinical study of sutureless, small-incision deep lamellar endothelial keratoplasty surgery].

OBJECTIVE: To investigate the surgical procedure, clinical efficacy, and the prevention and management of complications of sutureless, small-incision deep lamellar endothelial keratoplasty (DLEK). METHODS: Nine patients (nine eyes) with bullous keratopathy underwent sutureless, small-incision DLEK surgery, six of them was combined with anterior vitrectomy. Visual acuity, graft clearance, corneal curvature, astigmatism and endothelial cell density (ECD) were observed over a 3 - 5 month follow-up period. RESULTS: All grafts remained transparent, and six eyes had improved visual acuity. After the surgery, mean corneal curvature was (43.96 +/- 3.38) D. Mean corneal astigmatism was (3.32 +/- 1.20) diopter (D). Mean ECD was (2124 +/- 278) cells/mm(2). No severe complications occurred. CONCLUSION: Sutureless, small-incision DLEK, as compared with penetrating keratoplasty (PKP) and microkeratome-associated deep lamellar endothelial keratoplasty, has more advantages and is expected to be the initial surgical treatment for bullous keratopathy.