[Analysis of disease composition and primary surgical procedures in pediatric secondary glaucoma inpatients: a single-center study].

Objective: To analyze the disease composition and primary surgical procedures in pediatric inpatients with secondary glaucoma. Methods: A retrospective case series study was conducted. Clinical data of children aged≤16 years with secondary glaucoma who were admitted to the Zhongshan Ophthalmic Center, Sun Yat-sen University, between January 1, 2017, and December 31, 2021, were included. The patients were classified according to the Childhood Glaucoma Research Network (CGRN) classification system, and their diagnoses, underlying factors, gender, age of onset, affected eye(s), age and type of initial surgery, and ophthalmic examination data were analyzed. Statistical analysis was performed using Kruskal-Wallis rank sum test and χ2 test. Results: A total of 540 patients (744 eyes) were included in this study, comprising 319 males (59.1%) and 221 females (40.9%). Unilateral disease was observed in 336 cases (62.2%), while bilateral involvement was present in 204 cases (37.8%). The age of onset was 4.0 (0.0, 9.0) years, and the median age of the first anti-glaucoma surgery was 5.0 (0.7, 10.0) years. Among them, there were 195 cases (36.1%) of secondary glaucoma associated with non-acquired ocular anomalies (SCG-O), with a median age of onset of 0.0 (0.0, 4.0) years, and 97 of these cases (49.7%) were male. secondary glaucoma associated with non-acquired systemic disease or syndrome (SCG-S) were observed in 68 cases (12.6%), with a median age of glaucoma onset of 0.1 (0.0, 4.0) years, and 47 of these cases (69.1%) were male. Secondary glaucoma associated with acquired conditions (SCG-A) accounted for 192 cases (35.6%), with a median age of onset of 9.0 (5.0, 13.0) years, and 125 of these cases (65.1%) were male. There were 85 cases (15.7%) of secondary glaucoma following cataract surgery (SCG-C), with a median age of onset of 3.0 (0.8, 7.0) years, and 50 of these cases (58.8%) were male. Male patients were predominant in SCG-S and SCG-A, with 47 cases (69.1%) and 125 cases (65.1%), respectively (χ2=9.94, 17.52; P=0.002,<0.001). Except for SCG-O, all other types of pediatric secondary glaucoma predominantly affected only one eye: SCG-S in 52 cases (76.5%), SCG-A in 128 cases (66.7%), and SCG-C in 54 cases (63.5%) (χ2=19.06, 21.33, 6.22; all P<0.05). The highest proportion of SCG-O was attributed to congenital ectropion uveae (46 cases, 23.6%). Sturge-Weber syndrome was the most common SCG-S (45 cases, 66.3%), while SCG-A mostly resulted from trauma (59 cases, 30.8%) and corticosteroid use (56 cases, 29.2%). Trabeculectomy (211 eyes, 30.8%) and glaucoma drainage device implantation (197 eyes, 28.7%) were the most frequently performed primary surgical procedures. Conclusions: SCG-O and SCG-A were found to be common types of pediatric secondary glaucoma. The age of onset and the choice of primary anti-glaucoma surgical procedures varied among different types of pediatric secondary glaucoma. However, overall, trabeculectomy and glaucoma drainage device implantation were the primary surgical procedures predominantly employed.

Identification of potential mechanosensitive ion channels involved in texture discrimination during Drosophila suzukii egg-laying behaviour.

Drosophila suzukii (spotted wing drosophila) has become a major invasive insect pest of soft fruits in the America and Europe, causing severe yield losses every year. The female D. suzukii shows the oviposition preference for ripening or ripe fruit by cutting the hard skin with its serrated ovipositor. A recent study reported that mechanosensation is involved in the texture discrimination during egg-laying behaviour in D. suzukii. However, the underlying mechanism and molecular entity that control this behaviour are not known. The transient receptor potential (TRP) channels and degenerin/epithelial sodium channels (DEG/ENaC) are two candidate gene families of mechanically activated ion channels. Thus, we first identified TRP and DEG/ENaC genes in D. suzukii by bioinformatic analysis. Using transcriptome sequencing, we found that many TRP genes were expressed in the ovipositor in both D. suzukii and D. melanogaster, while some DEG/ENaCs showed species-specific expression patterns. Exposure to drugs targeting TRP and DEG/ENaC channels abolished the oviposition preference for harder texture in female D. suzukii. Therefore, mechanosensitive ion channels may play significant roles in the texture assessment of egg-laying behaviour in D. suzukii, which has promising implications to further research on the development of novel control measures.

Diffusion-weighted imaging (DWI) of hepatocellular carcinomas: a retrospective analysis of the correlation between qualitative and quantitative DWI and tumour grade.

AIM: To evaluate the application of qualitative and quantitative diffusion-weighted imaging (DWI) in predicting the histological grade of hepatocellular carcinoma (HCC). MATERIALS AND METHODS: Two hundred and fifty-four patients with pathologically confirmed HCC who underwent hepatic DWI on a 1.5-T platform (b = 0, 600 s/mm2) were evaluated retrospectively. HCCs were divided into well-, moderately, and poorly differentiated groups. The relationships between naked-eye signal intensity (SI), SI values, apparent diffusion coefficient (ADC) values on DWI, and the histopathological differentiation of HCC were analysed. Receiver operating characteristic (ROC) curves were drawn to determine the optimal operating points (OOPs) of the SI and ADC values to predict the tumour grade. RESULTS: A weak negative correlation (r=-0.350, p<0.05) was obtained between naked-eye SI and histological grade. There was a significant difference in mean SI values between well- (68.32±31.71) and moderately (102.39±45.55)/poorly (114.55±32.15) differentiated HCC but not between moderately and poorly differentiated HCC. The OOP of the SI value by ROC curve analysis was 66.5 to predict well-differentiated HCC. The mean ADC values of well-, moderately, and poorly differentiated HCC were 1.67±0.13×10-3, 1.31±0.16×10-3, and 1.08±0.11×10-3 mm2/s, respectively, with significant differences between any two combinations of groups. The OOPs of ADC to diagnose well- and poorly differentiated HCC were 1.5×10-3 and 1.24×10-3 mm2/s, respectively. CONCLUSION: Qualitative and quantitative SI and ADC values at DWI may be useful to estimate the histological grade of HCC preoperatively and non-invasively.

[Observation on the clinical effect of self-designed modified rhomboid skin flap in facial wound repair].

Objective: To investigate the clinical effect of self-designed modified rhomboid flap in repairing rhomboid, round, and teardrop-shaped wounds on the face. Methods: A retrospective observational study was conducted. From August 2018 to April 2020, 30 patients with facial lesions admitted into Ruijin Hospital Affiliated to Shanghai Jiao Tong University School of Medicine and the People's Hospital of Jianchuan County in Yunnan province met the inclusion criteria, including 16 males and 14 females, aged 23 to 88 years. The wound area ranged from 1.0 cm×1.0 cm to 7.0 cm×5.0 cm, with 10 cases of rhomboid wounds, 12 cases of round wounds, and 8 cases of teardrop-shaped wounds. The self-designed modified rhomboid flaps were applied to repair the wounds and after that, the patients were followed up for 1 to 18 months to record the survival of flaps, wound tension, scar formation and complications after surgery. Results: No necrosis or blackening was observed at the tip of the flaps after surgery. All the flaps survived and the wounds healed well with little tension, minimal scars, and no complications. Conclusions: The self-designed modified rhomboid flap is especially suitable for facial wounds with multiple important organs, multiple anatomical subunits, and areas with large changes in soft tissue tension, which can reduce not only the rotation of the flap, but also unnecessary excision of normal skin and soft tissue.

MiR-29 inhibits neuronal apoptosis in rats with cerebral infarction through regulating Akt signaling pathway.

OBJECTIVE: The aim of this study was to explore the influence of micro ribonucleic acid (miR)-29 on neuronal apoptosis in rats with cerebral infarction by regulating the protein kinase B (Akt) signaling pathway. MATERIALS AND METHODS: A total of 36 Sprague-Dawley rats were randomly divided into three groups, including: Sham group (n=12), Model group (n=12), and Inhibitor group (n=12). Common carotid artery, external carotid artery, and internal carotid artery were only exposed in the Sham group. However, the ischemia-reperfusion model was established by the suture method in the other two groups. After modeling, artificial cerebrospinal fluid was injected into the lateral ventricle in the rats of the Sham and Model groups. Similarly, miR-29 inhibitor was injected into the lateral ventricle in the rats of the Inhibitor group. At 24 h postoperatively, the sampling was performed. Zea-Longa score was used to evaluate the neurological deficit of rats. Meanwhile, the expressions of B-cell lymphoma 2 (Bcl-2) and Bcl-2 associated X protein (Bax) in cerebral tissues were detected via immunohistochemistry. The protein expression levels of Akt and phosphorylated Akt (p-Akt) were determined using Western blotting. Furthermore, the expression of miR-29 and cell apoptosis were detected via quantitative Polymerase Chain Reaction (qPCR) and terminal deoxynucleotidyl transferase (TdT) dUTP nick-end labeling (TUNEL) assay, respectively. RESULTS: Compared with Sham group, Model, and Inhibitor groups had substantially raised the Zea-Longa scores (p<0.05). The Zea-Longa score in the Model group was markedly lower than that of the Inhibitor group (p<0.05). The positive expression level of Bax was remarkably upregulated (p<0.05). However, the positive expression level of Bcl-2 declined dramatically in both Model group and Inhibitor group when compared with the Sham group (p<0.05). Besides, the Model group exhibited significantly lower positive expression level of Bax and higher positive expression level of Bcl-2 than the Inhibitor group (p<0.05). The relative protein expression level of p-Akt markedly increased in the Model and Inhibitor groups when compared with the Sham group (p<0.05). However, it was considerably higher in the Model group than that of the Inhibitor group (p<0.05). In comparison with the Sham group, both Model group and Inhibitor group exerted substantially elevated expression level of miR-29 (p<0.05). The relative expression level of miR-29 in the Model group was significantly upregulated when compared with the Inhibitor group (p<0.05). The apoptosis rate of cells in both Model group and Inhibitor group was markedly higher than that of the Sham group (p<0.05). Furthermore, the Model group showed remarkably lower apoptosis rate than the Inhibitor group (p<0.05). CONCLUSIONS: MiR-29 inhibits neuronal apoptosis in cerebral infarction rats by upregulating the Akt signaling pathway, thereby serving as a protector.

[Effects of transient exposure to high glucose on biological behaviors of human dermal microvascular endothelial cells].

Objective: To observe the effects of transient exposure to high glucose on biological behaviors of human dermal microvascular endothelial cells cultured in vitro. Methods: The dividing method and treatment of cells for the detection of all indexes in this study were as follows. Human dermal microvascular endothelial cells of the 4th passage were divided into 3 groups according to the random number table, with 12 wells in each group. Cells in control group (C) were cultured with complete culture solution containing 5 mmol/L D-glucose for 7 d. Cells in transient high glucose group (THG) were cultured with complete culture solution containing 30 mmol/L D-glucose for 2 d and complete culture solution containing 5 mmol/L D-glucose for 5 d. Cells in prolonged high glucose group (PHG) were cultured with complete culture solution containing 30 mmol/L D-glucose for 7 d. (1) The cell morphology in groups C and PHG on culture day 7 and that in group THG on culture day 2 and 7 was observed by inverted optical microscope. (2) On culture day 0, 2, 4, and 7, cell proliferation rate was determined by cell viability analyzing counter. (3) After culture day 2, the scratch experiment was performed, and the cells were further cultured. At post scratch hour (PSH) 0, 24, 48, 72, 96, and 120, the scratch area was measured, and the cell migration rates of the latter 5 time points were calculated. (4) On culture day 0, 2, 4, and 7, the cell apoptosis rate was determined by cell analyzer. (5) Cells were seeded into Matrigel to culture for 24 h after culture day 7. The formation of vessel-like structure was observed by inverted optical microscope. The length and number of branch point of vessel-like structure were calculated. (6) On culture day 2, 4, and 7, mRNA expression of vascularization-related gene tissue inhibitor of matrix metalloproteinase-3 (TIMP-3) was determined with real-time fluorescent quantitative reverse transcription polymerase chain reaction. Data were processed with analysis of variance of factorial design, analysis of variance for repeated measurement, one-way analysis of variance, and LSD test. Results: (1) Cells in group C exhibited ovary shape in cobble stone order on culture day 7. Cells in group THG exhibited long ovary shape and lost cobble stone order on culture day 2 and kept the same changes on culture day 7. Cells in group PHG exhibited long ovary shape and lost cobble stone order on culture day 7. (2) On culture day 0, there was no significant difference in cell proliferation rate among the 3 groups (F=0.23, P>0.05). On culture day 2, cell proliferation rates in groups THG and PHG were similar (P>0.05), which were significantly lower than the cell proliferation rate in group C (with P values below 0.01). On culture day 4 and 7, the cell proliferation rates in groups THG and C were similar (with P values above 0.05), which were significantly higher than those in group PHG (with P values below 0.01). (3) At PSH 24-120, the cell migration rates in groups THG and PHG were similar (with P values above 0.05), which were significantly lower than those in group C (with P values below 0.01). (4) On culture day 0, there was no statistically significant difference in cell apoptosis rate among the 3 groups (F=0.78, P>0.05). On culture day 2, cell apoptosis rates in groups THG and PHG were similar (P>0.05), which were significantly higher than the cell apoptosis rate in group C (with P values below 0.01). On culture day 4 and 7, the cell apoptosis rates in groups THG and C were similar (with P values above 0.05), which were significantly lower than those in group PHG (with P values below 0.01). (5) The length of vessel-like structure of cells in group THG was (1.84±0.10)×10(5) µm, close to (1.82±0.11)×10(5) µm in group PHG (P>0.05), both significantly shorter than (2.75±0.23)×10(5) µm in group C (with P values below 0.01). The numbers of branch point of vessel-like structure of cells in groups THG and PHG were 43±5 and 46±8 respectively, which were close to each other (P>0.05) and both significantly less than 103±21 in group C (with P values below 0.01). (6) On culture day 2, 4, and 7, mRNA expressions of TIMP-3 of cells in groups THG and PHG were similar (with P values above 0.05), which were significantly lower than those in group C (with P values below 0.05). Conclusions: Transient exposure to high glucose can cause metabolic memory of morphology, migration, and angiogenesis in human dermal microvascular endothelial cells cultured in vitro, resulting in sustained changes in biological behaviors. The mechanism may be related to the changes of vascularization-related genes.

Avoiding serious complications in laparoscopic cholecystectomy--lessons learned from an experience of 2428 cases.

Over a three-and-a-half year period, we performed 2428 cases of laparoscopic cholecystectomy (LC) and encountered 11 cases of serious procedure-related complications, including bile duct injuries in 4 patients, postoperative bleeding requiring laparotomy and haemostasis in 3 patients, bile leakage from the cystic duct stump, jejunal injury related to puncture, intraoperative injury to the duodenum and subdiaphragmatic abscess in 1 patient each respectively. Six patients required re-hospitalisation including 2 patients with pancreatitis, 1 patient with Ascaris cholangitis, 1 patient with residual stone of the common bile duct (CBD) after laparoscopic CBD exploration, 1 patient with a stone in the CBD after LC, and 1 patient with bile leakage from the cystic duct stump and peritonitis. Of the 2428 patients treated, there was only 1 operative mortality. This patient developed frequent episodes of supraventricular tachycardia. She was found to have pnuemonia on the 21st postoperative day and she died. Apart from this, 1 other patient was found to have primary cancer of the liver 1 month after LC. Based on our experience, we think that LC is safe for patients with benign disease of the gallbladder.

[Diagnosis and treatment of colonic wound. Analysis of 81 cases].

81 cases of colonic wound were treated in the last 10 years. In early diagnosis, attention was paid to clinical signs and a few untypical bu. specific signs of colonic injury. In the management of colonic injury, one stage operation must comply with 5 operative indications including correct approach to the dangerous factors affecting the result of the operation. Our cure rate of one stage operation was 97.5%. We preferred one stage surgery to two-staged operation because of the complications occurred following colonostomy. In this series the cure rate of two-stage procedure was 92.7%.

[Laparoscopic cholecystectomy performed in 235 cases of cholecystitis with impacted gallstones].

During the past 2 years, 235 cases of cholecystitis with impacted gallstones were treated with laparoscopic technique. There were 221 chronic cases and 14 acute cases accounting altogether for 15.19% of a total of 1475 patients undergoing laparoscopic cholecystectomy during the same period. As a result, 9 of these patients were converted to open surgery. Severe adhesion around the gallbladder or/and in the Calot triangle in 7, acute impacted gallstone, gallbladder necrosis along with obscure anatomy in the calot triangle in 1, and gallstone impacted at the junction of the common hepatic and cystic duct in 1 were observed. Conversion rate was 3.8%. Postoperative bile leakage developed in 2 cases and healed spontaneously. There were no intraperitoneal sepsis and perioperative death in our patients. The diagnosis, classification, and management for acute or chronic impacted gallstone are discussed.

Dopamine-related and caspase-independent apoptosis in dopaminergic neurons induced by overexpression of human wild type or mutant alpha-synuclein.

Human wild type (WT) and mutant alpha-synuclein (alpha-syn) genes were overexpressed using a Tet-on expression system in stably transfected dopaminergic MN9D cells. Their overexpression induced caspase-independent and dopamine-related apoptosis not rescued by general caspase inhibitor Z-VAD-FMK. While apoptosis due to overexpression of WT alpha-syn was completely abrogated by a specific tyrosine hydroxylase (TH) inhibitor, alpha-methyl-p-tyrosine (alpha-MT), the inhibitor only partially rescued apoptosis caused by overexpression of alpha-syn mutants. In addition, overexpression of mutants enhanced the toxicity of 1-methyl-4-phenylpyridinium (MPP+) and 6-hydroxyldopamine (6-OHDA) to MN9D cells, whereas overexpression of WT protected MN9D cells against MPP+ toxicity, but not against 6-OHDA. We conclude that WT alpha-syn is beneficial to dopaminergic neurons but its overexpression in the presence of endogenous dopamine makes it a potential threat to the cells. In contrast, mutant alpha-syn not only caused the loss of WT protective function but also the gain-of-toxicity which becomes more serious in the presence of dopamine and neurotoxins.

[Serological survey on mycoplasma infection among three populations in Yunnan Province].

Mycoplasma infection in both female and male genital tract has attracted attention recently. 636 infertile and sterile cases together with 284 women with IUDs and 113 women with genital inflammatory complications after artificial abortion were detected through indirect hemagglutination test for serological survey on the frequency of ureaplasma urealyticum (Uu) and mycoplasma hominis (Mh) infection. Some of them were detected through isolated culture at the same time. Among the 636 infertile and sterile cases, the results showed that the antibody positive rate to mycoplasma was 26.10%. Among women with IUD, the antibody positive rate was 32.39%. However, the antibody positives rates among women with IUD shorter than three months were significantly higher than those prior to and three to twelve months after insertion of IUD (P < 0.01). Among the 113 women after abortion, the positive rate was 46.02%. The positive rates of the three groups were significantly different from the control group (P < 0.001), and the antibody titers to mycoplasma were significantly higher than that of the control group. It is suggested that mycoplasma infection is one of the important causes for infertility and causing complication of genital inflammatory symptoms after abortion.