Regional brain changes in patients with diabetic optic neuropathy: a resting-state functional magnetic resonance imaging study.

BACKGROUND: To evaluate functional connection density (FCD) in patients with diabetic optic neuropathy (DON) using the resting functional connectivity (FC) method, and to determine the abnormal areas of brain activity. METHODS: Patients with DON (n=22; 10 male, 12 female) and healthy controls (HCs; n=22; 10 male, 12 female) were included in the study. The basic characteristics of the groups were matched. Functional magnetic resonance imaging (fMRI) was conducted with participants at rest, and long- and short-range FCD (long FCD and IFCD, respectively) were measured. Receiver operating characteristic (ROC) curve analysis was also conducted to determine whether DON and HC participants could be distinguished using fMRI indicators. RESULTS: Compared with HCs, the long FCD values of the left lingual gyrus, right lingual gyrus, right fusiform gyrus, and medial and lateral cingulate gyri were decreased in patients with DON. Further, the IFCD values of the left superior temporal gyrus, left inferior temporal gyrus, right inferior temporal gyrus, left cerebellar area 8, and right cerebellar Crus2 area were higher in patients with DON than in the HCs. CONCLUSIONS: DON is associated with abnormal spontaneous brain activity. Our findings contribute to elucidating the mechanisms underlying the neuropathology of DON, and provide direction for further clinical research.

Apolipoprotein A1 and Low-Density Lipoprotein as Risk Factors for Intraocular Metastases in Postmenopausal Breast Cancer.

BACKGROUND: The outcomes of patients with postmenopausal breast cancer(PBC) can be improved through the early detection of intraocular metastases(IOMs). In this study, we investigated patients with PBC, and compared those with IOMs with those with non-intraocular metastases(NIOMs) in terms of blood lipid levels, and then differentiated the risk factors associated with IOMs. METHODS: Student's t-test and a chi-square test were used to discriminate between the IOMs and NIOMs groups. After establishing a Poisson regression model to analyze risk factors, we plotted receiver operating characteristic curves(ROC) to assess the quality of risk factors predicting IOMs. RESULTS: The incidence of IOMs in PBC was 1.16%. There was no significant difference in terms of histopathology between the 2 groups. The levels of total cholesterol (TC), apolipoprotein A1(APOA1) and low-density lipoprotein(LDL) in IOMs were significantly lower than in NIOMs groups. Poisson regression suggested that low levels of APOA1 and LDL were risk factors for IOMs (P = 0.002 and P < 0.001, respectively). ROC curve analysis demonstrated that the cut-off values of APOA1 and LDL were 1.025 g/L and 2.415 mmol/L. The highest prediction accuracy for IOMs involved the combination of APOA1 and LDL (AUC = 0.881, P < 0.001). CONCLUSION: Our research demonstrates that low levels of APOA1 and LDL efficiently predict IOMs in PBC as risk factors, and the combination of APOA1 and LDL was more predictive than single factors.

The Prognostic Significance of Combined Pretreatment Fibrinogen and Neutrophil-Lymphocyte Ratio in Various Cancers: A Systematic Review and Meta-Analysis.

PURPOSE: The prognostic value of a new scoring system, termed F-NLR, that combines pretreatment fibrinogen level with neutrophil-lymphocyte ratio has been evaluated in various cancers. However, the results are controversial. The purpose of this study was to comprehensively analyze the prognostic value of F-NLR score in patients with cancers. METHODS: An integrated search of relevant studies was conducted by screening the PubMed and Embase databases. Pooled hazard ratios, with 95% confidence intervals (CIs), for overall survival (OS) and disease-free survival (DFS)/progression-free survival (PFS) were calculated to estimate the prognostic significance of F-NLR score in patients with various tumors. A random effects model was used for comprehensive analysis, and subgroup and meta-regression analyses were used to explore sources of heterogeneity. RESULTS: Thirteen articles reporting data from of 4747 patients were included in the study. Pooled analysis revealed that high F-NLR score was significantly associated with poor OS (HR = 1.77; 95% CI, 1.51-2.08) and poor DFS/PFS (HR = 1.63; 95% CI, 1.30-2.05). Subgroup and meta-regression analyses did not alter the prognostic role of F-NLR score in OS and DFS/PFS. CONCLUSIONS: Increased F-NLR score is significantly associated with poor prognosis in patients with cancers and can serve as an effective prognostic indicator.

Altered intrinsic functional connectivity of the primary visual cortex in patients with retinal vein occlusion: a resting-state fMRI study.

BACKGROUND: To investigate the differences of spontaneous functional connectivity (FC) of the primary visual cortex (V1) between patients with retinal vein occlusion (RVO) and healthy controls (HCs) using resting-state functional magnetic resonance imaging (rs-fMRI) data. METHODS: Twenty-one patients with RVO in total (11 males, 10 females) and 21 HCs similarly analogue in age and sex background were enrolled and inspected with rs-fMRI. The difference in FC of V1 between two groups were compared using two-sample t-test. We used the receiver operating characteristic (ROC) curve to distinguish average FC values of RVO subjects from HCs. The interrelationships between FC signals of specific cerebrum regions and clinical features in RVOs were assessed with the Pearson's correlation analysis. RESULTS: Compared with HCs, FC in left V1 and right middle frontal gyrus increased significantly in RVO group, while FC in left V1 and right cuneus decreased significantly. Meanwhile, patients with RVO presented increased FC between the right V1 and right middle frontal gyrus, right superior frontal gyrus, but declining FC between right V1 and right cuneus. The mean FC value between the right cuneus and the right V1 as well as the left V1 were negative correlated with the foveal thickness of RVO patients. ROC curve analysis of each brain regions showed the accuracy of AUC was excellent. CONCLUSIONS: RVO involves aberrant FC in V1 in different brain areas including visual-related and cognitive-related region, which might assist to unveil the underlying neural mechanisms of impaired visual function in RVO.

Ocular Metastasis in Elderly Lung Cancer Patients: Potential Risk Factors of CA-125, CA-153 and TPSA.

OBJECTIVE: At present, little is known regarding the specific risk factors of ocular metastasis (OM) in elderly patients with lung cancer. This study aimed to find out the risk factors of ocular metastasis. METHODS: A total of 1615 elderly patients with lung cancer were recruited into this retrospective study between April 2001 and July 2016. These patients were divided into two groups, namely OM and non-ocular metastasis (NOM). Student's t-tests, nonparametric rank sum tests, and Chi-square tests were applied to describe whether there were significant differences between the OM group and NOM group. We compared a range of serum biomarkers between the two groups of patients, including alkaline phosphatase, calcium, hemoglobin, alpha-fetoprotein, carcinoembryonic antigen, CA-125, CA-199, CA-153, CA-724, cytokeratin-19 fragment (CYFRA21-1), TPSA and neuron specific enolase (NSE). We used binary logistic regression analysis to determine the risk factors and receiver operating curve (ROC) analyses to assess the diagnostic value for OM in CRC patients. RESULTS: The incidence of OM in elderly patients with lung cancer was 2.0%. Binary logistic regression indicated that CA-125, CA-153, and total prostate specific antigen (TPSA) were identified as independent risk factors of OM in patients with lung cancer (P<0.001, P<0.001, and P=0.003, respectively). The sensitivity and specificity of OM diagnosis were as follows: CA-125, 81.25% and 81.57%; CA-153, 68.75% and 83.78%; and TPSA, 81.25% and 90.03%, respectively. CONCLUSION: The serum concentrations of CA-125, CA-153, and TPSA have predictive value in the diagnosis of OM in elderly patients with lung cancer.

Ocular Metastasis in Elderly Male Bladder Cancer Patients: Potential Risk Factors.

Bladder cancer is a common type of tumor among elderly male population; it causes intraocular metastasis (IOM). The study investigated the differences between elderly male bladder cancer patients with and without IOM, and identified risk factors for IOM. In this study, 749 elderly male patients (aged ≥50 years) with bladder cancer were included from November 2003 to December 2016. Differences between the IOM and non-IOM (NIOM) groups were evaluated by chi-square test and Student's t-test. The binary logistic regression analysis calculates the risk factors. Receiver operating characteristic (ROC) curve analysis was used to assess the diagnostic value of IOM in elderly male patients with bladder cancer. The incidence of IOM in patients with bladder cancer was 1.7%. No significant differences were detected in age and histopathology between the IOM and NIOM groups. According to the study, the IOM group had higher ALP and Cyfra21-1. Binary logistic regression indicated that ALP and Cyfra21-1 were risk factors for IOM in elderly male bladder cancer patients (p < .05). ROC curve analysis revealed area under the curve values for ALP and Cyfra21-1 of 0.913 and 0.814, using cutoff values of 9.65 and 83.5 U/L, respectively. The sensitivity and specificity values for ALP were 61.5% and 95.8%, respectively, while those for Cyfra21-1 were 84.6% and 73.3%. The investigation indicates that ALP and Cyfra21-1 are risk factors for IOM in elderly male patients with bladder cancer and ALP is more reliable at distinguishing IOM from NIOM in elderly male patients with bladder cancer.

Altered spontaneous brain activity pattern in patients with ophthalmectomy: an resting-state fMRI study.

AIM: To use the voxel-wise degree centrality (DC) method to explore the underlying functional network brain-activity in patients with ophthalmectomy. METHODS: A total of 32 ophthalmic surgery patients (10 women and 22 men), and 32 healthy subjects (10 women and 22 men) highly matched in gender, age, and the same operation method. Everyone experienced a resting-state functional magnetic resonance imaging scan. The spontaneous brain activity could be assessed by DC. Correlation analysis was used to explore the relationships between the average DC signal values and behavior performance in different regions. Receiver operating characteristic (ROC) curve analysis was utilized to differentiate between ophthalmectomy patients and healthy controls (HCs). RESULTS: Compared with HCs, ophthalmectomy patients had greatly reduced DC values in left lingual gyrus, bilateral lingual lobe, left cingulate gyrus, and increased DC values of left cerebellum posterior lobe, left middle frontal gyrus1, right supramarginal gyrus, left middle frontal gyrus2, right middle frontal gyrus. However, we did not find that there was a correlation between the average DC values from various brain regions and clinical manifestations. CONCLUSION: Dysfunction may be caused by ophthalmectomy in lots of cerebral areas, which may show the potential pathological mechanism of ophthalmectomy and it is beneficial to clinical diagnosis.

Carbohydrate antigen-125, calcium, and hemoglobin as predictive clinical indicator for ocular metastasis in male liver cancer patients.

Background Primary liver cancer (PLC) is a common type of cancer among men worldwide. Little is known regarding the relationship of liver cancer with ocular metastasis (OM). Drinking has been also reported to be related not only to the occurrence of liver cancer but also to the causes of some ocular lesions. Purpose A diagnostic standard for the levels of serum biomarkers associated with OM derived from liver cancer in men is urgently needed. Material and methods We examined the association between OM in liver cancer and its serum biomarkers. A total of 1254 male patients with liver cancer were recruited in this retrospective study between July 2002 and December 2012. We assessed the relationship between drinking preference and OM in male patients with liver cancer, and aimed to identify an independent prognostic factor or establish a quantitative indicator for OM. Results By assessing the potential indicators, carbohydrate antigen-125 (CA-125), calcium, and hemoglobin (Hb) were found to be most valuable in the diagnosis of OM in male patients with liver cancer. Conclusion CA-125, calcium, and Hb are independent risk factors of OM in patients with liver cancer who consume alcohol.

CEA as a risk factor in predicting ocular metastasis from colorectal cancer.

OBJECTIVE: Colorectal, closely following pulmonary and breast, is the third predilection site of cancer that lead to death all over the world. Ocular metastasis (OM) of colorectal cancer (CRC) is becoming increasingly common and presents a poor prognosis. In this study, we detected some recognized tumor biomarkers and tried to differentiate the discrepancy between CRC patients with and without OM in order to clarify the risk factor for OM in patients with colorectal cancer. METHODS: 1735 patients with colorectal cancer in total from August 2005 to August 2017 were involved in this study. Nonparametric rank sum test and Chi-square test were applied to prescribe whether there were significant differences between OM group and non-ocular metastasis (NOM) group. And binary logistic regression analysis was used to determine the risk factor. Then, we used receiver operating curve (ROC) to assess the diagnostic value of OM in CRC patients. RESULTS: The incidence of OM in CRC patients was 1.12%. No significant differences were found in gender, age, histopathological type, tumor classification and tumor differentiation between OM group and NOM group. Nonparametric rank sum test approved that OM group had higher serum CEA level compared with NOM group. Binary logistic regression indicated that CEA was a risk factor for OM in colorectal cancer patients (p<0.001). ROC curve showed that AUC of CEA was 0.877. The cutoff value of CEA was 12.45 ng/ml, whose sensitivity is 1.000 and its specificity is 0.877. CONCLUSION: Based on our study, CEA was a risk factor of ocular metastasis in colorectal cancer patients.

Diagnostic value of CA-153 and CYFRA 21-1 in predicting intraocular metastasis in patients with metastatic lung cancer.

Lung cancer is prone to metastasis to various organs. Although intraocular metastasis (IOM) occurs at a later stage than metastasis to other organs, it often adversely affects the quality of life and suggests a poor prognosis. In this study, we selected 1608 patients with lung cancer who had metastasis to at least one site and explored clinical differences between those with IOM and non-IOM (NIOM). An independent t test and chi-squared test were used to analyze the clinical features of the patients. The statistically significant parameters were analyzed by binary logistic regression to determine the risk factors for IOM. A receiver operating characteristic curve was constructed to assess their diagnostic value in IOM. The results showed that no significant differences were noted in age, gender, and pathological type between the IOM and NIOM groups. However, the IOM group had higher levels of alpha-fetoprotein, carcinoembryonic antigen, cancer antigen (CA)-125, CA-153, cytokeratin fragment 19 (CYFRA 21-1), and total prostate-specific antigen, compared with the NIOM group. Binary logistic regression indicated that CA-153 and CYFRA 21-1 were risk factors for IOM in patients with MLC (P < 0.05). Area under the curve of CA-153, CYFRA 21-1 and their combination were 0.791, 0.860, and 0.872 respectively. The cutoff values for CA-153 and CYFRA 21-1 were 22.2 U/mL and 6.785 ng/mL. In conclusion, both CA-153 and CYFRA 21-1 were independent risk factors for IOM in patients with metastatic lung cancer (MLC), whereas the combination of CA-153 and CYFRA 21-1 assessment yields the most value in the detection of IOM in patients with MLC.

Apolipoprotein A1 and B as risk factors for development of intraocular metastasis in patients with breast cancer.

Objective: Breast cancer is the most common primary lesion resulting in intraocular metastasis (IOM). In this study, we investigated the differences between breast cancer patients with and without IOM, and clarified the risk factors for IOM in patients with breast cancer. Methods: A total of 2,381 patients with breast cancer were included in this study from January 2005 to December 2017. The chi-square test and Student's t-test were applied to evaluate differences between the IOM and non-IOM (NIOM) groups. Risk factors were calculated using binary logistic regression analysis. Receiver operating curve (ROC) analysis was used to assess the diagnostic value of IOM in patients with breast cancer. Results: The IOM incidence in patients with breast cancer was 1.35%. No significant differences were detected in age, gender, menopausal status, or histopathology between the IOM and NIOM groups. The IOM group had more axillary lymph node metastases, lower ApoA1 and higher ApoB, compared with the NIOM group. Binary logistic regression indicated that ApoA1 and ApoB were risk factors for IOM in breast cancer patients (P-values<0.001 and P-values=0.005, respectively). ROC curve analysis revealed area under the curve values for ApoA1 and ApoB of 0.871 and 0.633, using cutoff values of 1.165 and 0.835 g/L, respectively. The sensitivity and specificity values for ApoA1 were 0.813 and 0.849, respectively, while those for ApoB were 0.813 and 0.481. Conclusion: Our data indicate that ApoA1 and ApoB are risk factors for IOM in patients with breast cancer and that ApoA1 is more reliable than ApoB at distinguishing IOM from NIOM in patients with breast cancer.

The predictive value of high-density lipoprotein for ocular metastases in colorectal cancer patients.

Purpose: Colorectal cancer (CRC) is a common tumor of the digestive tract that tends to metastasize and leads to high mortality. Ocular metastases (OM) from colorectal cancer are being increasingly diagnosed, and they can lead to a poor prognosis. Serum lipids are a known risk factor for cardiovascular disease, and are also relevant to the occurrence of CRC. In this study, we examined the levels of serum lipids and tried to determine whether there were correlations with the occurrence of OM in patients with colorectal cancer, in order to determine whether serum lipid levels may be a risk factor for OM in this patient population. Patients and methods: Records from a total of 703 patients treated for colorectal cancer from August 2005 to August 2017 were involved in this study. Student's t-tests, nonparametric rank sum tests, and Chi-square tests were applied to describe whether there were significant differences between the OM group and non-ocular metastases (NOM) group. We used binary logistic regression analysis to determine the risk factors and receiver operating curve (ROC) analyses to assess the diagnostic value for OM in CRC patients. Results: There were no significant differences in gender, age, histopathology type, or tumor classifications between the OM and NOM groups. The levels of serum TC, HDL, and LDL were significantly different between patients with and without lymph node metastases as well as male and female patients. The OM group had higher serum HDL levels compared to the NOM group. Binary logistic regression indicated that HDL was a risk factor for OM in colorectal cancer patients. The ROC curves showed that the AUC of HDL was 0.660. The cutoff value of HDL was 1.27 mmol/L, with a sensitivity of 0.619 and a specificity of 0.650. Conclusion: HDL levels are correlated with ocular metastases in colorectal cancer patients.

The role of pirfenidone in alkali burn rat cornea.

To evaluate the effects of pirfenidone in the treatment of HUVEC using an in vitro model and on rat corneal wound healing, edema, cornea neovascularization (CNV) and inflammation after alkali burn in vivo model. In vitro, CCK-8 assay was used to detect the effect of pirfenidone on the viability of HUVECs. The effects of pirfenidone on migration and tube formation of HUVEC were evaluated by HUVEC cell wound closure and tube formation assay. In vivo, Eye drops containing pirfenidone or phosphate buffered saline (PBS) were administered to an alkali-burn-induced corneal inflammatory and neovascularization model four times daily. The clinical evaluations, including fluorescent staining and cornea edema, were performed on days 1, 4, 7 and 14 using slit lamp microscopy. Global specimens were collected on day 7 and processed for immunofluorescent staining Collagen IV, α-smooth muscle actin (α-SMA), vascular endothelial growth factor (VEGF), pigment epithelium derived factor (PEDF) and cluster of differentiation34 (CD34). The levels of α-SMA, VEGF, PEDF, CD34, CD31 and nuclear factor-kappa B (NF-κB) proteins in the corneas were determined by western blot. Pirfenidone affects HUVEC viability, migration and tube formation in a dose-dependent manner. High concentration of pirfenidone can inhibit HUVEC viability, migration and tube formation in vitro and reduce alkali burn rat cornea edema, promote corneal wound healing, inhibit CNV and inflammation after alkali burn in vivo. Pirfenidone promotes corneal wound healing, and inhibits cornea neovascularization and inflammation after alkali burn in vitro and in vivo. Pirfenidone may be the potential anti-inflammation agent for the clinical treatment of CNV.