Correlation between severity of diabetic retinopathy and corneal SNP changes / 国际眼科杂志(Guoji Yanke Zazhi)

AIM:To investigate the correlation between severity of diabetic retinopathy(DR)and corneal sub-basal nerve plexus(SNP)changes. METHODS: There were 132 patients with 132 eyes in type 2 diabetes(T2DM)and 80 patients with 80 eyes in age-related cataract selected in our hospital from January 2018 to May 2021, among them, there were 52 non-diabetic retinopathy(NDR)patients with 52 eyes, 40 non proliferative diabetic retinopathy(NPDR)patients with 40 eyes and 40 proliferative diabetic retinopathy(PDR)patients with 40 eyes in T2DM. The general data and corneal laser scanning confocal microscopy were analyzed. Spearman rank correlation analysis was used to evaluate the correlation between DR clinical stage and nerve fiber length. RESULTS: There were no differences in gender and age comparisons among 4 groups(P>0.05). The diabetes duration in PDR group was significantly longer than NPDR group and NDR group(P<0.05). The diabetes duration in NPDR group was significantly longer than NDR group(P<0.05). The levels of fasting blood glucose and glycosylated hemoglobin in age-related cataract group were significantly lower than other three groups(P<0.05). The best corrected visual acuity in PDR group was significantly lower than NPDR group and NDR group(P<0.05). The best corrected visual acuity in NPDR group was significantly lower than NDR group(P<0.05). The length of nerve fibers in age-related cataract group was significantly higher than NDR group, NPDR group and PDR group(P<0.05). The length of nerve fibers in PDR group was significantly shorter than NPDR group(P<0.05). Spearman rank correlation analysis showed that there was a negative correlation between DR stage and nerve fiber length(rs=-0.347, P<0.001).CONCLUSION: There was a correlation between the severity of DR and the changes of corneal SNP. The length of nerve fibers in patients with PDR was significantly shorter than patients with NPDR; Both PDR and NPDR have a loss of neural structure and should pay attention to the evaluation and treatment of ocular surface lesions in the treatment of T2DM fundus lesions.

Application of Achilles Tendon Total Rupture Score in Acute Achilles Tendon Rupture / 中国康复理论与实践

Objective:To explore the validity of Achilles Tendon Total Rupture Score (ATRS) for rehabilitation after Achilles tendon rupture. Methods:From January, 2012 to December, 2016, 50 patients with acute Achilles tendon rupture were enrolled. The original table of ATRS was translated, organized and evaluated to obtain the ATRS consensus version. At the 1st month, 2nd month, 3rd month, 6th month and 12th month follow-up, the scores of American Orthopaedic Foot and Ankle Society Ankle-hindfoot scale (AOFAS-AH) and ATRS were recorded. Results:Three patients were dropped out. The scores of both AOFAS-AH and ATRS increased with time, and gradually became flat. The total score of AOFAS-AH was significantly positively correlated with the total score of ATRS (ρ = 0.961, P < 0.001). Conclusion:ATRS can be used in evaluating the functional recovery of Achilles tendon repair.

Relationship Between Body Fat Indices and Hypertension Level by Quantitative CT: A Multicenter Study in Chinese Population / 中国循环杂志

Objectives: To explore the relationship between body fat indexes and hypertension levels by quantitative CT (QCT) study. Methods: A total of 1488 participants from "prospective urban-rural epidemiology (PURE) study" were enrolled. The participants' age were from 42 to 82 years; based on blood pressure (BP) they were divided into 2 groups: Non-hypertension group, n=783 and Hypertension group, n=705. QCT fat measurement software was used to examine L2 level abdominal visceral adipose tissue (VAT) and subcutaneous adipose tissue (SAT); body mass index (BMI), waist circumferences (WC), hip circumferences (HC) and waist-to-height ratio (WHtR) were measured and calculated; liner Logistic regression analysis and 2-classified Logistic analysis were conducted to study the relationships between hypertension and anthropometric indices, abdominal VAT, SAT respectively. Results: Compared with Non-hypertension group, Hypertension group had increased BMI, WC, HC, WHtR, abdominal VAT and SAT, P<0.05. BMI, WC, HC, WHtR, abdominal VAT and SAT were related to both systolic BP (SBP) and diastolic BP (DBP), P<0.05. Multivariable Logistic regression analysis indicated that WHtR, abdominal VAT, SAT were the independent impact factors of SBP and WC, abdominal VAT were the independent impact factors of DBP; further investigation showed that abdominal VAT and WC were the independent impact factors of hypertension. Conclusions: Abdominal VAT was robustly related to hypertension in Chinese population, it might be helpful for risk stratification in hypertension patients.

Preparation and physicochemical characterization of levofloxacin-loaded poly(lactic-co-glycolic acid) nanoparticles / 中国组织工程研究

BACKGROUND:Conventional formulation of levofloxacin is rapidly and completely metabolized after administration. Fortunately, nanoparticle provides a new way to solve this problem. OBJECTIVE:To prepare a levofloxacin-loaded poly(lactic-co-glycolic acid) (PLGA) nanoparticle that can reduce administration frequency, maintain a stable and effective plasma concentration, and also can be combined with tissue-engineered scaffold materials. METHODS:Levofloxacin-loaded PLGA nanoparticles were prepared by emulsion solvent evaporation method. Twenty-four rabbits were taken to investigate the effect of nanoparticle formulation on the pharmacokinetics of levofloxacin and randomized into three groups (n=8 per group): general formulation group received an injection of levofloxacin (20 mg/kg)via ear vein; non-loaded nanoparticle group received an injection of blank nanoparticles; and levofloxaxin-loaded nanoparticle group received an injection of the corresponding levofloxacin-loaded nanoparticles. At different times, blood samples were collected to analyze the drug concentration of levofloxaxin. The antimicrobial activity of the levofloxacin-loaded nanoparticle was evaluated based on the rabbit model of Escherichia coli-induced urinary tract infection. Forty-five New Zealand white rabbits were used to establish urinary tract infection models and randomly divided into three groups (n=15 per group). In negative control group, rabbits received only an injection of normal salinevia ear vein. In conventional formulation group, rabbits received an injection of levofloxacin (20 mg/kg). In nanoparticle group, rabbits received an injection of the corresponding levofloxacin nanoparticles. Subsequently, blood samples were obtained, and white blood cell (WBC) count and neutrophil percentage was tested; at the same time, the middle segment morning urine was collected to detect bacteriuria and urine WBC positive rates. At 9 days, the histopathologic analysis of the bladder mucosa was done. RESULTS AND CONCLUSION:(1)In vivo the pharmacokinetics: Compared with the conventional formulation group, the ideal levofloxacin-loaded PLGA nanoparticles prepared under optimal conditions significantly reduced the fluctuations in plasma concentration and frequency of administration. (2) Antimicrobial activity:Escherichia coli-induced urinary tract infection was gradualy in control in the conventional formulation group and levofloxacin-loaded PLGA nanoparticle group, and basically cured at 9 days after injection. In addition, the number of cured patients was basically higher in the levofloxacin-loaded PLGA nanoparticle group than the conventional formulation group at the same time point, but there was a significant difference between the two groups only at 5 days after treatment. It can be concluded that levofloxacin-PLGA nanoparticles provide a well-sustained delivery system for treatment or prevention of urinary tract infections and provide a foundation for further investigations on tissue-engineered urethral reconstruction.

Continued sustained release of VEGF by PLGA nanospheres modified BAMG stent for the anterior urethral reconstruction of rabbit

OBJECTIVE@#To study the biocompatibility and neovascularization of the PLGA nanospheres wrapped with vascular endothelial growth factor (VEGF), which can improve bladder acellular matrix graft (BAMG) with local continuous release of VEGF.@*METHODS@#A total of 18 rabbit model (length of stenosis: 3 cm) with anterior urethral stricture were used as experimental animals and divided into three groups. Group A as the control group: Simple BAMG scaffold materials for urethral reconstruction. Group B as the blank group: PLGA microspheres modified BAMG for urethral reconstruction. Group C: PLGA conjugated with VEGF and modified BAMG for the urethral reconstruction. All rabbits underwent urethral angiography after 7 days, 15 days, 1 month and 3 months after the operation, and one rabbit in each group was sacrificed to be prepared for the organization histologic examination, HE staining, masson staining, CD31, 34 and a-SAM immunohistochemical detection in the repaired sites.@*RESULTS@#In group A, significant urethral restenosis occurred in two rabbits after 15 days of the operation, HE and masson staining showed a lot of collagen arranged in the repaired sites, and there were a large number of inflammatory cell infiltration, and there were also CD31, 34 in the repaired sites. a-SAM microvascular tag count showed a small amount of microvascular; Group B showed anastomotic restenosis, HE and masoon staining showed inflammatory cell infiltration and collagen deposition; Group C: urethrography showed lumen patency. There were a small amount of inflammatory cell infiltration after 7 and 15 days after the operation, and there were also CD31, 34 in the repaired sites. The a-SAM microvascular tag count showed many microvascular. And the difference was significant.@*CONCLUSIONS@#Anterior urethral reconstruction with sustained-release of VEGF by PLGA nanospheres modified BAMG stents can reduce postoperative restenosis. It can also reduce collagen deposition and scar formation, promote angiogenesis of the repair tissue; therefore it in valuable in the tissue-engineered urethral reconstruction.

Comparison of surgical intervention with functional treatment for acute ruptures of lateral ankle ligmant: a meta-analysis

OBJECTIVE@#To compare the effect of surgical intervention on functional treatment.@*METHODS@#By searching the MEDLINE (1966 to October 2011), EMBASE (1980 to October 2011), the Chinese Biomedical Database Databases (1980 to October 2011), a total of 9 related RCT studies comparing surgical intervention with functional treatment were included in our study. RevMan software was taken to analyze the data.@*RESULTS@#These 9 studies involved a total of 1 268 mostly young adults, including 580 patients with surgical treatment and 688 patients with functional treatment. The results showed the stability of ankle activity in surgical treatment group was better than that in functional treatment group, with the OR and 95% CI of 0.72 (0.52-0.99). No significant difference was found in the recurrence of the surgical and functional group. However, the movement disorder in the surgical treatment suggested increased risk than that in functional group, with the OR and 95% CI of 2.39 (0.98-5.85). Surgical group found more complication than the function group, such as deep vein thrombosis, deep venous thrombosis, tenderness of scar and sensory loss.@*CONCLUSIONS@#In conclusion, our finding showed that surgical treatment could gain better efficacy than functional treatment, but may bring more complication. Therefore, further large sample size RCT is warranted.

Effects of lycium bararum polysaccharides on blood glucose, blood fat and blood-retinal barrier in diabetic rats / 中华实验眼科杂志

Background The characters of diabetic retinopathy (DR) include capillary occlusion,microcirculation disturbance and retina neovascularization near ischemic areas of the retina.The pathogenic mechanism is still incompletely clear,but the primary mechanism of DR is the change of permeability of retinal blood capillary.Objective The aim of this study was to investigate the effect of lycium bararum polysaccharides (LBP) on the blood glucose,blood fat and permeability of blood-retinal barrier in diabetic rats.Methods Fifty-four clean adult SD rats were randomized into 4 groups.The diabetes mellitus models were created in 36 SD rats by injection of 45 mg/kg streptozotocin(STZ) via caudal vein.The rats with the blood glucose ＞ 16.7 mol/L were defined as the diabetic mellitus in 72 hours after injection.LBP of 200 rmg/( kg · d) was intragastriccally administered in 18 models once a day in LBP group,and equal volume of normal sodium was used at the same way in 18 models in DM group,and 18 normal rats were as normal control group.The rats were killed in 4,8 and 12 weeks respectively for the detect of blood glucose level,triglyceride,total cholesterol.The retina tissue were isolated for the quantification of vascular permeability using Evans blue method.Results The blood glucose level was significantly elevated in the DM group and LBP group compared with normal control group,and that in LBP group was obviously declined in comparison with the DM group with a 57％,40％,36％ fall off in 4,8,12 weeks respectively,showing a statistically significant differences( P＜0.05 ).The triglyceride concentration was considerably raised in the DM group compared with normal control group in all of the time points( P＜0.01 ),however,the rise of triglyceride concentration was found only in 12 weeks in LBP group(P＜0.05).The cholesterol level was increased in 8 and 12 weeks in DM group compared with normal control group and that of LBP group went up only in 12 weeks (P＜0.0l ).The Evans blue contents in dry retina tissue were(26.23±2.00),(29.78± 1.78 ) and( 34.08±3.03 ) μg/g in 4,8,12 weeks in the DM group,and those of LBP were ( 13.27 ±0.77 ),( 18.01 ± 1.77 ),( 25.05 ±:1.50 ) μg/g,showing statistical differences between two groups ( P＜0.01 ).However,in comparison with normal control group ( 12.34 ±4.30,12.76 ± 2.11,12.45 ±4.40 μg/g),the Even blue content were elevated in various time points (P＜0.01 ).Conclusions LBP can suppress the increase of the blood-retinal barrier permeability in STZ-induced diabetic rat by lowing the levels of blood glucose,triglyceride and total cholesterol.These results suggest that LBP has a therapeutical effect on DR.

Peri-operative management of fracture in patients with diabetes mellitus / 中华外科杂志

<p><b>OBJECTIVE</b>To study the characters of the treatment of perioperative period in fractures with diabetes mellitus (DM) and the effect of diabetes on the treatment of them.</p><p><b>METHODS</b>To retrospectively analyze the clinical data of 97 fracture patients with DM (DM group) who accepted operation. Compare the difference of the average hospitalized length, medical cost and the incidence of postoperative complications with the controls.</p><p><b>RESULTS</b>(1) Insulin dosage was less in postoperative period (0.5 +/- 0.2) U.d(-1).kg(-1) than steady period (0.7 +/- 0.2) U.d(-1).kg(-1) and operative period (0.7 +/- 0.3) U.d(-1).kg(-1), the difference is significant (P < 0.05); (2) There were more complications in DM group than that in the control group before operation. The fractured patients with DM could receive operation after preoperative treatment and improving micro-circulation; (3) Compared with control group, DM group had longer preoperative preparation period of in-hospital duration, and higher in-hospital medical costs; (4) There were no significant difference between DM group and control group (P > 0.05) in postoperative complications and wound healing.</p><p><b>CONCLUSIONS</b>Fractured patients with DM should take effective methods to treat complications of DM and do adequate preparation for the operation. Rational treatment of preoperative complications is very important for preventing postoperative one and guarantee operation successful. But the longer of hospitalized length is, the higher of in-hospital medical costs are.</p>