Reflections on a case of Vogt-Koyanagi-Harada syndrome first diagnosed in internal medicine: a case report.

BACKGROUND: A case of Vogt-Koyanagi-Harada syndrome (VKH) first diagnosed with encephalitis was reported and it bring us the clinical reflection. CASE DESCRIPTION: A 73-year-old Chinese woman was first diagnosed in the department of neurology with headache, nausea, vomiting, and elevated body temperature. Cerebrospinal fluid (CSF) assays showed significant increases in leukocytes and Cerebrospinal fluid total protein (CS-TP). Gradually, symptoms appeared in the eyes including decreased vision, keratic precipitates (KP) (+++), iris local posterior adhesion, vitreous opacity, and optic disc congestion edema. The fundus fluorescence examination showed optic disc hyperfluorescence with both eyes exudative retinal detachment. Type-B ultrasonography of obit showed a large number of flocculent opacities in the vitreous and retinal edema. Optical coherence tomography (OCT) showed that significant edema was evident in the macular area and papillary, and there were wavy changes in the retinal pigment epithelium layer. Review of the clinical, photographic, fundus fluorescence angiography (FFA) data of the patient suggested a clinical diagnosis of VKH. CONCLUSIONS: VKH is an autoimmune disease involving many systems. It has specific systemic symptoms, such as tinnitus, dizziness, headache, nausea, skin injury and so on. But Neurological and auditory manifestations usually precede the involvement of other sites especially in the neurological manifestations. So we should pay attention to the diversity of clinical manifestations, so as to avoid delaying treatment or even misdiagnosis in clinical diagnosis and treatment.

[Determination of lipophilic marine biotoxins in shellfish foods by ultra performance liquid chromatography-hybrid triple quadrupole linear ion trap-mass spectrometry].

OBJECTIVE: An ultra performance liquid chromatography-hybrid triple quadrupole linear ion trap-mass spectrometry(UPLC-QqLIT-MS) was established for determination of lipophilic marine biotoxins in shellfish. And the 12 lipophilic marine biotoxins in shellfish were surveyed. METHODS: The lipophilic marine biotoxins in homogenized shellfish were ultrasonically extracted by methanol in super-sonic instrument, and cleaned up by solid phase extraction of Strata-X column, and eluted with methanol(containing 0.3% ammonia water). The elution was diluted with water, and cleaned by 0.22 µm millipore filter. The filtrate was separated on a Waters ACQUITY UPLC BEH C_(18) column(150 mm×2.1 mm, 1.7 µm)by gradient elution in 12 minutes with acetronitrile-water(containing 0.01%(V/V) ammonia and 2 mmol/L ammonium formate) as mobile phase, and detected by ultra performance liquid chromatography-tandem mass spectrometry(UPLC-MS/MS), identified by electrospray ionization(ESI) in simultaneous scanning mode of positive and negative ions using multiple reaction monitoring, and quantified with external standards. Information dependent acquisition scan function(IDA) combined with enhanced production scan(EPI) was used to confirm the 12 lipophilic marine biotoxins. RESULTS: The calibration curves of 12 lipophilic marine biotoxins showed good linearity in the range of 0.5-50 µg/L with correlation coefficients were 0.9984-0.9999.The detection limits of the method were 0.15-0.29 µg/kg. The recoveries of three spiking levels ranged from 80.0% to 116.0%, and the relative standard deviation(RSD) were 0.6%-6.4%(n=7). CONCLUSION: The method for determination of 12 lipophilic marine biotoxins in shellfish by UPLC-QqLIT-MS was of operation convenience, less interference from impurities and good accuracy, which could meet the requirements for the determination of 12 lipophilic marine biotoxins residues in sea foods.

Analysis of the efficacy and safety of Danshen Dripping pills on the eyes of diabetic retinopathy patients with Qi stagnation and blood stasis.

OBJECTIVE: To analyze the efficacy and safety of compound Danshen dripping pills (CDDPs) in the treatment of patients with diabetic retinopathy (DR) with the syndrome of Qi stagnation and blood stasis. METHODS: The clinical data of 81 patients with DR admitted to our hospital were analyzed retrospectively, and the patients were divided into an observation group (n=40) and a control group (n=41) in accordance with a random number table. The observation group was treated with CDDPs, while the control group was treated with Captopril. The response rates, change of severity degrees of retinopathy, improvement of vision, incidence of macular edema and symptom scores were compared between the two groups. RESULTS: (1) The ratio of decreasing degree of severity of retinopathy in the observation group was greater than that in the control group, while the ratio of increasing degree of severity of retinopathy in the observation group was lower than that in the control group (P < 0.05). There was no significant difference in the constant ratio of degree of severity of retinopathy between the two groups (P > 0.05). (2) After treatment, the scores for dim vision, somber facial complexion, dry eyes, encrusted skin and numbness of the limbs in the observation group were lower than those in the control group (P < 0.05). (3) The overall response rates (ORRs) were 87.50% and 63.41% in the observation group and the control group, respectively (P < 0.05). (4) After treatment, the vision in the left and right eye in the observation group was higher than those in the control group (P < 0.05). (5) The incidence rates of macular edema were 12.50% and 31.71% in the observation group and the control group, respectively (P < 0.05). CONCLUSION: CDDPs can effectively elevate the response rate, reduce the degree of severity of retinopathy, mitigate the incidence of macular edema, and improve the vision of DR patients with the syndrome of Qi stagnation and blood stasis, exhibiting a satisfactory safety profile. Therefore, it has a good application value.

Simultaneous removal of Zn2+ and p-nitrophenol from wastewater using nanocomposites of montmorillonite with alkyl-ammonium and complexant.

Three types of alkyl-ammonium with different branching chains and three complexants with different functional groups were used to prepare alkyl-ammonium or complexant intercalated montmorillonite nanocomposite (A-Mt or C-Mt). In addition, synergistic intercalated montmorillonite nanocomposites (A/C-Mt) with alkyl-ammonium along with complexant were also prepared. The adsorption performance of the various nanocomposites toward Zn2+ and p-nitrophenol (PNP) from simulated binary wastewater containing both Zn2+ and PNP were systematically investigated. Characterization of Mt nanocomposites showed that both alkyl-ammoniums and complexants were successfully intercalated into the interlayers of Mt. The surfactant loading amounts of the various nanocomposites were also determined and correlated with the resulting expansion of the interlayer spacing. It was found that intercalation of alkane (OTAC) and -SH (CSH) were conducive to the adsorption of Zn2+ while -C2H4NH (TETA) and all alkyl-ammoniums were beneficial for PNP adsorption. The extent of adsorption was found to be controlled primarily by pH, i.e., the higher pH had a good effect on the adsorption of both Zn2+ and PNP. The adsorption process of Zn2+ onto Mt nanocomposites was more in line with the Freundlich model (R2 = 0.99), while the Langmuir model described the adsorption of PNP well (R2 = 0.99). The adsorption kinetics could be well described by the Elovich equation (R2 = 0.98) and the double-constant model (R2 = 0.89). Chemical adsorption was determined to be the dominant process between the contaminant and Mt nanocomposite surfaces.

Synthesis and Characterization of a Dual-Cation Organomontmorillonite Nanocomposite.

In this study, a novel dual-cation organomontmorillonites (OMt) nanocomposite was synthesized by two kinds of modifiers cetyltrimethylammonium chloride and cysteamine hydrochloride, and the adsorption behavior of modifiers into montmorillonite (Mt) has been investigated. The OMt were characterized by techniques, such as X-ray diffraction (XRD), Fourier Transform Infrared (FTIR) spectroscopy, and thermogravimetric and differential thermal (TG-DTA) analyses. The effects of temperature, contact time, the order of addition and the concentration of organic modifiers on the amounts of organics adsorbed were investigated. The adsorption amount of cetyltrimethylammonium chloride (CTAC) and cysteamine hydrochloride (CSH) increased with the increase of the added CTAC amount and contact time, while the addition order of modifiers and modification temperature had no significant effect on the actual adsorption amount of CTAC and CSH on Mt, as confirmed by the XRD patterns. The experimentally determined isotherms showed a good fit with the Langmuir adsorption models. The adsorption kinetics demonstrated that the adsorption of CTAC and CSH by Mt followed the pseudo-second-order model, and CTAC adsorption rate on Mt was faster than that of CSH. FTIR spectrum clearly revealed the incorporation of surfactant ions into the interlayer region. The TG-DTA analyses showed that the total mass losses of OMt strongly depended on the molecular volume of modifiers.

[Determination of 7 penicilins and penicilloic acids in milk products by high performance liquid chromatography-tandem mass spectrometry].

OBJECTIVE: A high performance liquid chromatography-tandem mass spectrometric method was established for determination of 7 penicilins (cloxacillin, nafcillin, oxacillin, penicillin V, amoxicillin, penicillin G, ampicillin) and their penicilloic acids (cloxacilloic acid, nafcilloic acid, oxacilloic acid, penicilloic acid V, amoxicilloic acid, penicilloic acid G and ampicilloic acid) in milk products. And the 7 penicilins and penicilloic acids in milk products were surveyed. METHODS: The 7 penicilins and penicilloic acids in milk products were extracted by water in super-sonic instrument , precipitated proteins by acetonitrile and degreased fat by n-hexane with liquid-liquid extraction, then the purified solution was concentrated by nitrogen, dissolved with acetonitrile-water (10 + 90, V/V) and cleaned by 0.22 µm millipore filter. The filtrate was detected by high performance liquid chromatography-tandem mass spectrometry, identified by electrospray ionization (ESI) in positive mode using multiple reaction monitoring, and quantified with external standards. RESULTS: The calibration curves of 7 penicilins and penicilloic acids showed good linearity in the range of 1.0-200 µg/kg with correlation coefficients were above 0.9992. The detection limits of the method were from 0.03 µg/kg to 0.15 µg/kg. The recoveries of three spiking levels ranged from 80.0% to 110.0%, and RSDs of 7.06% or less were obtained. CONCLUSION: The method for determination of 7 penicilins and penicilloic acids in milk products by HPLC-MS/MS was of operation convenience, less interference from impurities and good accuracy, which could meet the requirements for the determination of 7 penicilins and penicilloic acids residues in milk products.

Combined silicone oil removal with secondary implantation of anterior chamber or sclera-fixed posterior chamber intraocular lenses.

PURPOSE: To compare the outcomes and complication rates of silicone oil removal (SOR) combined with secondary implantation of modern anterior chamber intraocular lenses (AC IOLs) versus scleral-fixated, posterior chamber IOLs (SF IOLs) in patients who lack capsular support.
 METHODS: A prospective, nonrandomized study was performed to compare 2 groups of patients between January 2006 and February 2011. Forty eyes of 40 patients undergoing AC IOL implantation (group 1) and 34 eyes of 34 patients undergoing SF IOL implantation (group 2) were included. The mean follow-up was 22.3 ± 6.3 (range 6-42) months. 
 RESULTS: The mean postoperative corrected distance visual acuity (CDVA) recorded at the last follow-up in groups 1 and 2 was 0.70 ± 0.50 and 0.65 ± 0.55, respectively (p = 0.71). A total of 35 eyes (87.5%) and 29 eyes (85.3%) in groups 1 and 2 had an improved or unchanged CDVA; 5 eyes (12.5%) and 5 eyes (14.7%) had a deteriorated CDVA. The most frequent postoperative complications in the 2 groups were transient corneal edema, elevated intraocular pressure, hypotony, and retinal detachment. The differences in the number of eyes and the total number of complications were not statistically significant for early (p = 0.06) and late (p = 0.13) complications between the 2 groups. 
 CONCLUSIONS: Both secondary AC IOL and SF IOL implantation with simultaneous pars plana approach of SOR are suitable for treating silicone oil-filled, aphakic eyes. No significant difference in visual outcome or major complication rates was found between the 2 groups.

A gene expression profile of the developing human retinal pigment epithelium.

PURPOSE: The molecular mechanisms associated with human retinal pigment epithelium (RPE) development constitute the basis for cell replacement therapy for the treatment of retinal degenerative diseases. In the current study, gene expression analysis of the human fetal RPE during development was performed and was compared with the human native RPE. METHODS: Microdissection of the human RPE at three time points (13 weeks and 16 weeks of gestation and in mature adult eyes) was performed, and total RNA was isolated. Equal amounts of RNA were pooled from two or three independent donor eyes for each time point in each group. Gene expression was analyzed by hybridization to microarray chips. Validation was accomplished by comparing the microarray expression profiles with quantitative real-time reverse transcriptase-polymerase chain reaction (qRT(2)-PCR) analysis of selected genes and by comparing selected expression profiles with predicted profiles based on previous studies. RESULTS: Of the 45,033 probe sets on the microarray, 30,736 were detected. A total of 3,498 differentially expressed genes could be clustered into eight patterns of expression that were statistically significant. Analysis of the expression patterns of genes coding for key functions (pigment synthesis, visual cycle, phagocytosis, adherens and tight junctions, and transcellular transport) indicated that the human RPE achieves a high degree of maturity during early pregnancy. Compared with 154 signature genes in the RPE, 148 candidate genes were identified in this study, including 53 downregulated genes and 5 upregulated genes. The qRT(2)-PCR results showed similar expression trends to those obtained by microarray analysis at the three time points. CONCLUSIONS: This study demonstrated gene expression profiles in the human RPE during normal development. These findings indicate that the human RPE has different expression patterns than those of other animals. The results of this study may be helpful in furthering the understanding of the developmental processes occurring in humans and of the differentiation of RPE cells derived from human embryonic stem cells and from human induced pluripotent stem cells.