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Cataract is the leading cause of blindness worldwide, and the common mechanism for its onset and development is oxidative damage to the lens.The expression of a large number of antioxidant genes is regulated by nuclear factor erythroid 2-related factor 2 (Nrf2), and the Nrf2 oxidative defense system is one of the main defense systems for antioxidant damage in the body.The activity of Nrf2 signaling pathway is primarily regulated by Kelch-like ECH-associated protein 1 (Keap1), and Keap1 mediates Nrf2 protein degradation thereby inhibiting the activation of the Nrf2 pathway in a Keap1-dependent manner.Increasing research has revealed other mechanisms of Nrf2 regulation in a Keap1-independent manner, including phosphorylation and acetylation of Nrf2 (PKC, PI3K/Akt, JNK, and P300/CBP) and epigenetic factors (promoter methylation, histone modification, and microRNAs-144, -28 and -34). Reduced expression of Nrf2 and its downstream antioxidant genes has been shown to play an important role in the onset and development of various types of cataracts.Many compounds, such as morin, hyperoside, sulforaphane, rosae laevigatae extract, 3-n-butylphthalide, and acetyl-L-carnitine, have been found to be able to upregulate the expression of antioxidant genes by activating Nrf2 signaling pathway to protect lens epithelial cells from oxidative stress to prevent or alleviate cataract.This article reviewed recent researches on Nrf2 signaling pathway and the relationship between Nrf2 activators and cataract to provide a theoretical basis for the prevention and treatment of cataract.
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Objective:To investigate the correlation between thromboelastography (TEG) and portal vein thrombosis in patients with cirrhotic esophagogastric varices.Methods:210 hospitalized patients with cirrhotic esophagogastric varices treated in Zhongshan Hospital Affiliated to Fudan University from December 2016 to December 2017 were retrospectively included. They were divided into portal vein thrombosis group (PVT group) and non portal vein thrombosis group (NPVT group) according to whether they were complicated with portal vein thrombosis. The correlation between the results of TEG coagulation reaction time (R value), coagulation time (K value), αAngle, maximum amplitude (MA) and coagulation composite index (CI) and portal vein thrombosis was analyzed. The characteristics of coagulation status in patients with portal vein thrombosis in cirrhosis were compared.Results:A total of 91 patients (43.3%) were complicated with portal vein thrombosis. The R value in the PVT group was significantly lower than that of NPVT group [5.49(5.22-5.77) vs 5.98(5.76-6.20), P=0.006]. Logistic regression analysis showed that Child Pugh grade ( OR=2.883, 95% CI: 1.630-5.098, P<0.001) and R value ( OR=0.739, 95% CI: 0.575-0.950, P=0.018) were independently associated risk factors of PVT. The R value of patients was significantly correlated with Child Pugh grade ( r=0.147, P=0.034), platelet ( r=-0.358, P<0.001), prothrombin time (PT) ( r=0.334, P<0.001) and international standardized ratio (INR) ( r=0.328, P<0.001). Conclusions:The decrease of TEG-R value is closely related to PVT in liver cirrhosis.
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Objective Our purpose was to investigate the pathogenic gene mutation of a Han Chinese family with vitreous amyloidosis.Methods The 9 individuals(proband,1 affected member and 7 unaffected members) of the family were selected and their DNA was extracted from peripheral blood.The 4 exons of transthyretin(TTR) gene were amplified by polymerase chain reaction(PCR) technique.The amplified products of TTR gene were sequencing by Sanger technique.We also selected 100 unrelated healthy individual as the control group.Results By DNA sequencing,a heterozygous mutation was found in 4 of the 9 subjects from the family.The transition of adenine to cytosine(AAG ＞ ACG) was detectable in exon 2 of TTR,which changed the amino acid composition at codon 35 (Lys35Thr).This mutation did not presented in control group.Conclusion The heterozygosis mutation of TTR gene Lys35Thr should be a pathogenic mutation for the family with vitreous amyloidosis.
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Background Fungal keratitis is one of primary infectious ocular diseases in China.Conventional diagnostic method is fungal cultivation.In vivo laser confocal microscope is a noninvasive examination of ocular surface.However,the study on features of in vivo laser confocal microscope images of frequent fungal keratitis is still not thorough.Objective This study was to analyze laser confocal microscope imaging features of four typical fungal keratitis.Methods The clinical data of 65 eyes from 65 patients with fungal keratitis were retrospectively analyzed.The patients were initially diagnosed in Nanjing General Hospital of Nanjing Military Command PLA from January 2007 to November 2011, and laser confocal microscope examination of ocular surface and fungal cultivation were performed.The characteristics of laser confocal microscope images were investigated,including shape and type of hypha,distribution of spores and the relationship of hypha with lesion.The differentiation between fungal hypha and other corneal tissues was summarized.Results Fungal cultivation showed that among the 65 patients,Fusarium,Aspergillus,Candida and Alternaria were common pathogenic fungus with the infected proportion 63.0％ , 16.9％,3.0％ and 4.6％ ,respectively, and 12.5％ patients were infected by other fungus.In the images of laser confocal microscope,hyphae of Fusarium presented the branch-like high reflective structure in the corneal superficial stromal layer and thinning line shape in the deep stromal layer.Few inflammatory cells were found.The peudohyphae and spores from Candida were seen in corneal superficial and mid stroma layers, with few inflammatory cells and many proliferating stromal fibers in the lesions.The hyphae of Aspergillus presented worm-like, showing the thinner and shorter shapes in comparison with those of Candida.The hyphae of Alternaria were long,straight and thick in shape,and spherical chlamydospores were found on the hyphal tip.The hyphae, subepithelial plexus, dendritic cells, fibrosis of the cornea all showed high reflection under the laser confocal microscope, but evidently differences appeared in shape,distribution and course in corneas.Conclusions Hyphae are the main basis to diagnose fungal keratitis and differentiate fungi.As a non-invasive examination method,laser confocal microscope can provide useful information for the early diagnosis and treatment of fungal keratitis in vivo.
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Refractive surgery for myopia is a common operation and has been performed on millions of patients .Improved technology has increased the satisfaction of patients and physicians .Surgery must follow the basic requirements of medical ethics , to ensure the safety and best interests of the patients .The choice of procedure depends on individual patient indications and ocular exami -nations .Before the surgery , the opthalmologists must ensure that the patient understands the potential risk of the operation and has re -alistic expectations for the visual acuity postoperatively .
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Objective Acrysof IQ Restor multifocal toric intraocular lens ( IOL) is a new product , which allows a single sur-gical procedure for presbyopia correction and corneal astigmatism management .This study was to evaluate the early clinical effects of phacoemulsification cataract surgery with implantation of a diffractive multifocal toric IOL . Methods We retrospectively analyzed 7 cases (9 eyes) of corneal astigmatism ≥1.0 diopter (D) treated by phacoemulsification with implantation of an Acrysof IQ Restor toric IOL.The patients were followed up for 3 months for observation of uncorrected distance visual acuity ( UDVA) , best corrected distance visual acuity ( CDVA) , uncorrected near visual acuity ( UNVA ) , best corrected near visual acuity ( CNVA ) , spherical equivalent (SE) refraction, focal depth, residual astigmatism, rotational stability of the IOL, contrast sensitivity (CS), and spectacle independ-ence preoperatively and at 1 week, 1 month, and 3 months after operation . Results At 3 months after surgery , the UDVA ( log-MAR), CDVA, UNVA, and CNVA were 0.07 ±0.10, 0.02 ±0.11, 0.12 ±0.06, and 0.08 ±0.07, respectively, with an SE re-fraction within ±0.50 D of the attempted spherical correction in 8 eyes (88.9%) and a focal depth of (5.32 ±1.78) D.The residual astigmatism at 3 months was significantly reduced as compared with the baseline ([0.25 ±0.28] vs [1.55 ±0.39] D, P0.05).At 3 months, the mean IOL axis rotation was (3.11 ±1.61)°and CS was remarkably im-proved ( P0.05) except at 18.0 cpd (P<0.05). Conclusion Implantation of the Acrysof IQ Restor multifocal toric IOL provides excellent overall quality of vision, spectacle independence, visual quality, and rotational stability for patients with cataract and corneal astigmatism.
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Objective Xerophthalmia is a common disease of the ocular surface .Lupus nephritis ( LN) may induce changes in the ocular surface , which has aroused increasing attention in ophthalmology .This study was to observe the morphological changes of the tear meniscus in LN patients with xerophthalmia after treated with artificial tears . Methods This clinical trial included 60 LN patients with xerophthalmia (120 eyes) and another 60 without.The xerophthalmia group received artificial tear eye-drops for 1 month. The tear meniscus height (TMH), tear meniscus depth (TMD), and tear meniscus area (TMA) were measured by anterior segment optical coherence tomography ( AS-OCT) before and after intervention . Results There were significant differences between the xe-rophthalmia and control groups in the baseline TMH ([0.159 ±0.051] vs [0.269 ±0.053] mm, P<0.01), TMD ([0.154 ± 0.012] vs [0.198 ±0.007] mm, P<0.01), and TMA ([0.021 ±0.069] vs [0.052 ±0.021] mm2, P<0.01).After 1 month of intervention with artificial tears, the xerophthalmia patients showed dramatically increased TMH ([0.179 ±0.014] vs [0.159 ± 0.051] mm, P<0.01), TMD ([0.163 ±0.015] vs [0.154 ±0.012] mm, P<0.01), and TMA ([0.040 ±0.017] vs [0.021 ± 0.069] mm2, P<0.01). Conclusion AS-OCT, with its advantages of clearly and objectively imaging and measuring the cross section of the tear meniscus , can be applied to the diagnosis and assessment of xerophthalmia in LN patients , and artificial tear eye-drops can effectively relieve their xerophthalmia symptoms .
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Objective To clone and express the hexon protein of three prevalent human adenovi -rus strains causing respiratory disease and analyze the antigenic characteristics of the recombinant proteins . Methods The full length genes encoding hexon protein of human adenovirus serotype 3(HAdV3), serotype 4(HAdV4) and serotype 7(HAdV7) were cloned by PCR and sequenced , respectively.The alignment anal-ysis was performed by using hexon gene sequences from GenBank .The major antigenic regions of hexon pro-tein of the three serotypes were expressed in E.coli and purified.The antigenicity, immunogenicity and cross reactivity of the recombinant proteins were determined by ELISA and Western blot assay .Results The full length gene sequence encoding hexon protein of human adenovirus serotype 4 was firstly reported in China , which showed more than 99%homology in both nucleotide and amino acid sequences with the human adeno-virus type 4 NHRC3 strain.The partial hexon protein sequence of HAdV 3, HAdV4 and HAdV7 containing all of the 7 hyperviriable regions ( HVRs) were expressed in E.coli, respectively .The purified recombinant proteins could be recognized by antiserum of the three serotypes of adenovirus .The antiserum samples against the three recombinant proteins could cross-react with particles of the three serotypes of adenovirus . The possible type-and species-specific epitopes were predicted .Conclusion The major antigenic regions of hexon protein of the three serotypes were successfully expressed .The purified recombinant proteins contai-ning both intertypes and type-specific epitopes showed a strong immunogenicity .
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ObjectivesTo explore the serum insulin-like growth factor-1 (IGF-1)levels in the patients with unresectable or metastatic gastrointestinal stromal tumors before and after imatinib treatment and to discuss its clinical significance.MethodsThe serum samples of27 patients with unresectable or metastatic gastrointestinal stromal tumors were collected before imatinib treatment(before treatment group) and three months after imatinib treatment(after treatment group).The other serum samples were collected from 20 healthy volunteers who were accepting health examination (control group). The serum IGF-1 levels of the samples were determined by enzyme-linked immunosorbent assay (ELISA).ResultsThe mean serum IGF-1 levels were significantly higher in before treatment group than in control controls[(463.61±120.98)ng/ml vs.(115.75±39.27) ng/ml, t=12.355,P=0.000)]. Three months after imatinib treatment,the mean serum IGF-1 levels were significantly lower in after treatment group than in before treatment group [(244.64±100.11)ng/ml vs.(463.61±120.98) ng/ml, t=7.582,P=0.000].ConclusionsSerum IGF-1 levels may help to judge therapeutic effect,progression,recurrence or metastasis of the gastrointestinal stromal tumor.
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Objective To explore changes of serum fibroblast growth factor 2 (FGF2) levels after treatment with imatinib mesylate in patients with unresectable or metastatic gastrointestinal sromal tumor.Methods Serum FGF2 levels (with ELISA) were determined in 27 patients with unresectable or metastatic gastrointestinal stromal tumor both before and after treatment with imatinib mesylate.Results Before treatment with imatinib mesylate,of 27 cases of unresectable or metastatic gastrointestinal stromal tumor,17 cases (63.0 ％) were found positive for serum FGF2,after treatment with imatinib mesylate,9 cases (33.3 ％) were found positive for serum FGF2 (P ＜ 0.05).Using imatinib mesylate for 3 months,complete remission rate was 0,partial remission rate was 51.9 ％ (14/27),stable disease rate was 48.1％ (13/27) and progressive rate was 0.Conclusion Patients with unresectable or metastatic gastrointestinal stromal tumor have elevated serum FGF2 levels.Imatinib mesylate treatment can reduce serum FGF2 levels in patients with unresectable or metastatic gastrointestinal stromal tumor.
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Objective To investigate the effects of imatinib mesylate on recurrent or metastatic gastrointestinal stromal tumor.Methods Thirty-five cases of patients with recurrent or metastatic gastrointestinal stromal tumors treated with Imatinib mesylate from January 2007 to February 2010 in our hospital were analyzed retrospectively.Results After treated with Imatinib mesylate for 3 months,complete remission rate was 2.9％( 1/35 ),partial remission rate was 45.7％ ( 16/35 ),stable disease rate was 51.4％ ( 18/35 ) and progressive rate was 0;clinical benefit rate was 100％.The 2-year overall survival rate was 97.1％.The 2-year progression free survival was 82.9％.Conclusion Imatinib mesylate is effective for recurrent or metastatic gastrointestinal stromal tumors and the treatment is safe and reliable.
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Objective To evaluate the relationship between aged diabetes mellitus and cognitive impairment in community elders.Method 308 type Ⅱ diabetic patients, including 225 diabetes patients and 164 diabetes with hypertension patients, were random selected in our study. 225 hypertension and 186 healthy elders were random selected as controls. Mini-Mental State Examination (MMSE) was tested on each case. According to DSM-IV, all participants were classified into three groups ( normal, MCI and dementia) .Result MMSE scores in diabetes patients were lower than that in healthy controls(25. 87±3.33 vs 26. 86 ±2. 82, F = 9.62, P < 0. 01), and scores in diabetes with hypertension group (24. 68 ±4. 36 ) were much lower than that in healthy controls ( F =37. 16, P <0.01). Conclusion Senile diabetes were positive correlated with cognitive impairment. Diabetes were a risk factor of dementia in seniles. Diabetes with hypertension can increase cognitive impairment in community elders.
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0.05). Women with triple negative breast cancer experienced more lymph node metastases (71.9%︰58.5%,P=0.034),with the higher percentage of more than 10 lymph nodes metastases(26.0%)as compared with Her-2-overexpressing breast cancer (12.2%,P=0.034). A higher percentage of histological grade 3 was identified in triple-negative (67.7%)than in Her-2-overexpressing breast cancer(42.1%,P0.05). However,significantly poorer 5-year DFS was seen in patients with triple negative phenotype (61.85 months)than with Her-2-overexpressing phenotype (78.69 months,P=0.047). Conclusion Triple-negative breast cancers were more aggressive,and these women had poorer DFS comparing with Her-2-overexpressing ones.
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Retinal neovascularization is a phenomenon observed in various kinds of eye diseases and it can threaten the visual function of patients. Medical treatment to inhibit retinal neovascularization will give them effective help. This article reviewed animal models of retinal neovascularization and researching development of medicine in this field.
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Objective:To observe the changes in the anterior chamber before and after cataract surgery by ultrasound biomicroscopy (UBM) in eyes with primary angle closure glaucoma. Methods: Ultrasound biomicroscopy was used for anterior chamber imaging in 78 eyes of 50 patients with primary angle closure glaucoma before and 1 month after cataract phacoemulsification and intraocular lens implantation. And the intraocular pressures were recorded at the same time. Results: UBM allowed the imaging of the entire anterior eye segment. In the images, the differences between iris thickness (IT), iris zonule distance (IZD) and iris lens angle (?2) before and after the operation were statistically insignificant. After the operation, marked increases were observed in the anterior chamber depth (ACD), angle opening distance at 500 ?m from the scleral spur (AOD500), trabecular iris angle (?1) and trabecular ciliary process distance (TCPD), with statistically very significant differences from preoperation (P
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Objective: To investigate the ultrastructural pathogenesis of retina injury by observing the ultrastructural changes under the transmission electron microscope(TEM) after ocular blast injury in rabbits.Methods: Ocular blast injury models were set up in 20 rabbits by the bow wave produced with a bioshock tube.The rabbits were sacrificed at scheduled times after injury,their retinas obtained and their ultrastructural changes observed by TEM.Results: The axonal ultrastructural changes of the retina induced by blast were summarized as follows.The microfilaments and microtubules were swollen and distorted in the early stage,followed by reactive swelling of the ganglion cells.The swollen mitochondria and endoplasmic reticula focally accumulated and the cytoskeleton was destroyed.Finally the intraaxonal cellular structure disappeared and the axon disconnected.Conclusion: Ocular blast injury may cause retinal ultrastructural changes.The pathological changes of ganglion cells in the optic nerve may be associated with the direct effect of the blast and/or ischemia and are possibly important factors in the pathogenesis of vision disturbance.
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Objective: To study the effect of ?-cyanoacrylate on corneal perforation in rabbits. Methods:Eighteen adult rabbits were divided into a left eye group and a right eye group.Bilateral corneas of the rabbits were perforated and subsequently occluded with ?-alkyl cyanoacrylate synthetic adhesive in the former group and by separated single points using the 10-0 polyglactin thread in the latter.The time for the obliteration of the corneal perforations and intraocular pressure(IOP) were recorded preoperatively and 3 days after the operation in both the two groups.The ocular contents of the two groups were observed by slit-lamp biomicroscopy after the operation.Results: The mean time of the corneal perforation obliteration was shorter in the left than in the right eyes.IOP was recovered to normal within 3 days postoperatively and the ocular contents were stabilized,with no significant difference in IOP between the two groups 3 days after the operation.Conclusion: ?-Cyanoacrylate is an effective adhesive agent for corneal perforation.
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Objective:To evaluate the therapeutic effects and value of preserved amniotic membrane combined with conjunctival autograft transplantation for recurrent symblepharon. Methods:A group of 38 eyes in 38 patients with recurrent symblepharon due to recurrent pterygium,chemical burn and other causes were undertaken preserved amniotic membrane combined with conjunctival autograft transplantation.The patients were followed for 6 to 36 monthes.Results:No infections occurred.The amniotic membrane changed into transparent 10 days postoperatively.The conjunctival epithelium emigrated to the surface of amniotic membrane.Impression cytology showed a stable conjunctival epithelium on the surface of amniotic membrane.Efficient movement ability was recovered in 34 eyes(89.5%).Four eyes(10.5%) were still restricted in movement due to partly recurrent symblepharon.Conclusion:The preserved amniotic membrane combined with conjunctival autograft transplantation for is effective recurrent symblepharon
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Objective:To observe the flap complications after LASIK and analyze their clinical characters and treatment. Methods:The flap complications after LASIK in 35 eyes of 27 patients was reviewed.Visual acuity were measured at 3,7,15,30,60 days after the operation,at the same time, the eyes were examined with slit lamp. Results:After the therapy,diffuse lamellar keratitis of 10 eyes were recovered in 1 to 2 months,the visual acuity were 0.8 to 1.5.Flap slippage of 9 eyes were treated with replacement and the visual acuity were 1.0 to 1.2.One eye with trauma induced flap lose underwent allogeneic keratomileusis and the visual actity was 0.5 to 0.6.One eye with interface infection was treated by removing the infected flap and PTK.The corneal surface was healed but remained with little haze.The visual acuity were 0.8 to 1.0 after the therapy in three eyes with epithelial ingrowth.Three eyes with fiap breaking in the procedure were reoperated half a year later,and the visual acuity were 1.0 to 1.2. Conclusion:Flap complications after LASIK occurred at various period and are related with surgical technic,patient~(,)s eyes conditions and the treatment after the surgery.Early detection and therapy can obtain an comparatively excellent recovery.
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The technique of amniotic membrane transplantation is developping rapidly in treating ocular surface disease recently. Amniotic membrane is widely used in this area due to its unique structure, procurment and graft puparation. The authors describe the methods of processing and preservation of human amniotic membrane, and the histological study and clinical application experiences as well.