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Background In mainland China, patients with neovascular age-related macular degeneration (nAMD) have approximately an 40% prevalence of polypoidal choroidal vasculopathy (PCV). This disease leads to recurrent retinal pigment epithelium detachment (PED), extensive subretinal or vitreous hemorrhages, and severe vision loss. China has introduced various treatment modalities in the past years and gained comprehensive experience in treating PCV.Methods A total of 14 retinal specialists nationwide with expertise in PCV were empaneled to prioritize six questions and address their corresponding outcomes, regarding opinions on inactive PCV, choices of anti-vascular endothelial growth factor (anti-VEGF) monotherapy, photodynamic therapy (PDT) monotherapy or combined therapy, patients with persistent subretinal fluid (SRF) or intraretinal fluid (IRF) after loading dose anti-VEGF, and patients with massive subretinal hemorrhage. An evidence synthesis team conducted systematic reviews, which informed the recommendations that address these questions. This guideline used the GRADE (Grading of Recommendations, Assessment, Development, and Evaluation) approach to assess the certainty of evidence and grade the strengths of recommendations. Results The panel proposed the following six conditional recommendations regarding treatment choices. (1) For patients with inactive PCV, we suggest observation over treatment. (2) For treatment-na?ve PCV patients, we suggest either anti-VEGF monotherapy or combined anti-VEGF and PDT rather than PDT monotherapy. (3) For patients with PCV who plan to initiate combined anti-VEGF and PDT treatment, we suggest later/rescue PDT over initiate PDT. (4) For PCV patients who plan to initiate anti-VEGF monotherapy, we suggest the treat and extend (T&E) regimen rather than the pro re nata (PRN) regimen following three monthly loading doses. (5) For patients with persistent SRF or IRF on optical coherence tomography (OCT) after three monthly anti-VEGF treatments, we suggest proceeding with anti-VEGF treatment rather than observation. (6) For PCV patients with massive subretinal hemorrhage (equal to or more than four optic disc areas) involving the central macula, we suggest surgery (vitrectomy in combination with tissue-plasminogen activator (tPA) intraocular injection and gas tamponade) rather than anti-VEGF monotherapy. Conclusions Six evidence-based recommendations support optimal care for PCV patients' management.
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OBJECTIVE: To investigate the correlation between non-alcoholic fatty liver disease and visceral adipose tissue in non-obese Chinese adults using computed tomography (CT). MATERIALS AND METHODS: The study included 454 subjects undergoing abdominal CT scan. Degree of CT attenuation in liver and spleen, and the degree of fat infiltration in liver were evaluated according to three indices: the attenuation value of liver parenchyma (CTLP), the attenuation ratio of liver and spleen (LSratio) and the attenuation difference between liver and spleen (LSdif). Visceral fat area (VFA) and total fat area (TFA) at L2/3 and L4/5 levels were measured, and the abdominal subcutaneous fat area (SFA) was calculated. Bivariate correlation analysis was carried out to determine the correlation among these factors. RESULTS: In men, VFA, SFA and TFA at L2/3 and L4/5 levels showed significant differences in terms of the three indices to distinguish fatty liver from non-fatty liver (all, p < 0.001). In men, all the three indices showed negative correlation with TFA, SFA and VFA (all, p < 0.001). The negative correlation between the three indices and VFA at the L2/3 level was higher than at L4/5 level (r = −0.476 vs. r = −0.340 for CTLP, r = −0.502 vs. r = −0.413 for LSratio, r = −0.543 vs. r = −0.422 for LSdif, p < 0.001, respectively). The negative correlation between LSratio, LSdif and VFA at L2/3 and L4/5 levels was higher than SFA at the corresponding level. In women, all the three indices showed negative correlation with VFA and TFA at L2/3 and L4/5 levels, and the negative correlation between CTLP and VFA was higher at L2/3 level than at L4/5 level (r = −0.294 vs. r = −0.254, p < 0.001). CONCLUSION: In non-obese Chinese adults, the degree of hepatic fatty infiltration showed a strong correlation with abdominal fat on CT. VFA at L2/3 level was more closely related to fatty liver compared with VFA at L4/5 level.
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Adult , Female , Humans , Male , Abdominal Fat , Asian People , Fatty Liver , Intra-Abdominal Fat , Liver , Non-alcoholic Fatty Liver Disease , Spleen , Subcutaneous Fat, Abdominal , Tomography, X-Ray ComputedABSTRACT
Objective To explore the role of integrin αvβ3 in the promotion of the development of choroidal neovascularization (CNV) by SDF-1/CXCR4.Methods This study was divided into two parts in vitro and in vivo.As for the in vivo study,a CNV model was induced by laser on C57BL/6J mice,and then assigned into 4 groups:mice with solely CNV modeling as control group,with intravitreal injection of SDF-1 after immediate CNV modeling as SDF-1 group,with intravitreal injection of SDF-1 + CXCR4 inhibitor (AMD3100) after CNV modeling as SDF-1 + AMD3100 group,and mice with intravitreal injection of SDF-1 + αvβ3 inhibitor (SB273005) after modeling as SDF-1 + SB273005 group.CXCR4 and αvβ3 expression levels in laser-induced eyes were quantified by qRT-PCR at time points of day 1,3,5,7,10 and 14 after modeling,and immunofluorescence staining was applied to detect αvβ3 expression in regional CNV and its endothelial cells in the four groups.Finally,OCT was used to observe the height of retinal pigment epithelial (RPE) layers in CNV after treatment in the four groups.Moreover,in the experiment in vitro,Western blot was used to measure the expression of CXCR4 protein of RF/6A cells in normal control group,Si-CXCR4 knockdown group and Si-NC knockdown model group.Meanwhile,the expression of integrin subunit β3 protein was determined in the normal control group,SDF-1 group,SDF-1 + AMD3100group,SDF-1 + Si-NC group and SDF-1 + Si-CXCR4 group.Transwell assay was conducted to detect the migration ability of RF/6A cells in the normal control group,SDF-1group,SDF-1 +AMD3100 group,SDF-1 + SB273005 group.Results On the one hand,the study in vivo,qRT-PCR showed that the expression of CXCR4 and integrin subunit β3 mRNA was up-regulated at first,and then down-regulated with time passed after CNV induction,with the highest expression level of CXCR4 mRNA (4.263 ± 0.464) on day 3,and the peak expression of β3 mRNA (3.678 ±0.364) on day 7 after CNV modeling.The results of immunofluorescence staining showed that the β3 fluorescence intensity of SDF-1 group was significantly enhanced,and the ratio of β3/CD31 was also significantly increased,which both were significantly higher than those of the control group (P ＜ 0.01).However,the β3 fluorescence intensity and β3/CD31 ratio of SDF-1 +AMD3100 group and SDF-1 + SB273005 group were significantly weakened and decreased,respectively (P ＜0.05).OCT showed that the elevation level of RPE layer inSDF-1 group was significantly higher than that in the control group [(135.503 ± 10.301) μm vs.(94.443 ± 12.156) μm](P＜0.05).The height of RPE uplift in SDF-1 + AMD3100 group [(95.283 ±20.062) μm] and SDF-1 + SB273005 group [(99.807 ± 10.403) μm] was significantly decreased (P ＜ 0.05).On the other hand,in experiment in vitro,Western blot showed that the expression levels of integrin β3 in SDF-1 group and SDF-1 + Si-NC group were significantly higher than those in the control group [(1.301 ± 0.043) and (1.273 ± 0.077) vs.(0.244 ± 0.069)] (P ＜ 0.01).The levels of integrin subunit β3 protein in SDF-1 + si-CXCR4 group (0.322 ± 0.042) and SDF-1 + AMD3100 group (0.336 ± 0.077) were significantly down-regulated (P ＜ 0.01).Transwell assay showed that the amount of migrating cells in SDF-1 group increased,which was significantly higher than that of the control group (P ＜ 0.01),while the number of migrating cells in SDF-1 +AMD3100 group and SDF-1 + SB273005 group was significantly decreased.Conclusion Integrin αvβ3 can promote the development of CNV by mediating SDF-1/CXCR4 signaling in endothelial cells.
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·AIM: To investigate the effect and mechanism of Caspase- 1 on microglia in oxygen - induced retinal neovascularization in mice. ·METHODS: Twelve 7-day-old (P7) C57BL/6J mice were randomly divided into normal group,OIR group and OIR+VX-765 group. OIR models were established in OIR group and OIR+VX-765 group. Caspase-1 inhibitor VX-765(4mg/kg, dissolved in 0.4% polyethylene glycol) or 0. 4% polyethylene glycol, were intraperitoneally injected from P12 to P16 into the mice of OIR+VX-765 and OIR groups,respectively. Whole retinal flatmounts of P17 mice were prepared, and Lectin staining was performed to calculate the ratio of avascular and neovascular area to retina area. The frozen sections of the posterior ocular segment were prepared,and the distribution of Caspase-1 and activated microglial cells were detected by immunofluorescence technique. Cultured BV-2 cells were divided into control group, hypoxia group and inhibitor group. The cells of inhibitor and hypoxia groups were pre-treated with VX-765 or 0.4% polyethylene glycol for 3h, and then hypoxic incubated for 24h. The expression levels of Caspase-1, p20 (active form of Caspase-1), IL-1β and VEGF were detected by Western blotting. The angiogenesis and migration capacity of cultured RF/6A cells were assessed by endothelial cell tube formation assay and migration assay,after they were incubated with supernatant of those different BV-2 groups. ·RESULTS:The distribution and morphology of retinal blood vessels were normal in P17 mice of the normal group,and avascular and new blood vessel cluster were found in the mice of OIR group and OIR+VX-765 group. The ratio of avascular area was 12.23% ±1.02% and that of the new blood vessel area was 2.16% ±0.52% in the OIR+VX- 765 group, which decreased in comparison with 16.58% ± 1.14% and 4.00% ± 0.41% of the OIR group(P<0.01 ). Caspase - 1 was rarely detected by immunofluorescence staining in the normal retina of the mice, whereas it was mainly co-located with activated microglial cells in the ganglion cell layer and the inner plexiform layer in the mice of OIR group. The expression of Caspase-1, p20, IL-1β and VEGF increased in BV-2 cells of the hypoxia group, which were down-regulated by VX-765(P<0.05), except Caspase-1. The tube length was 271±12,and the number of migrated cells was 347±34 in RF/6A cells cultured with supernatant of BV-2 cells in the hypoxia group, which significantly decreased to 171 ± 22 and 212±27 with inhibitor of Caspase-1 (P<0.05). · CONCLUSION: Caspase - 1 promotes retinal neovascularization in the mice with OIR, probably by activating the downstream inflammatory factor IL-1β in microglial cells and accelerating the release of VEGF.
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AIM:To investigate the amniotic membrane transplantation for all the cornea or bandage contact lens after pterygium excision combine with limbal stem cell transplantation in the treatment of large pterygium.METHODS:The 40 eyes of larger pterygium was randomly divided into 2 groups,one group,20 eyes,with autologous limbal stem cell transplantation combine with amniotic membrane transplantation for all the cornea (amniotic membrane group);another group,20 eyes,with bandage contact lens after limbal stem cell transplantation (bandage contact lens group).The surgery time,eye comfort postoperation,progress in corneal healing were observed at 1,3d,1 and 3wk.RESULTS:The average surgery time of amniotic membrane transplantation group was 61.4±5.2min,and the bandage contact lens group was 34.5±2.7min,which was significantly shorter (Student's t-test,P＜ 0.05).There was no difference of the degree of eye comfort between the two groups at first day after surgery.But 3d and 1wk postoperation,the degree of ocular comfort of bandage contact lens group was much better than amniotic membrane transplantation group (P＜ 0.01),while there was no difference between the two groups 3wk after surgery (P＞0.05).The corneal healing score of the two groups was 0.85±0.18 and 1.15±0.18 in the 3wk after operation respectively,and the difference between the two groups was not statistically significant (Student's t-test,P=0.25).There was only one case of recurrence in amniotic membrane group.CONCLUSION:Treatment of larger pterygium with amniotic membrane transplantation for all the cornea or wearing bandage contact lenses after autologous limbal stem cell transplantation,can both ease eye symptoms and promote corneal wound healing.Those patients with bandage contact lens feel more comfortable and convenient than with autologous limbal stem cell transplantation.Also the bandage contact lens surgery is more economical than the other one.
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AIM: To analyze the clinical features of children ocular penetrating trauma,and hope to effectively assist to prevent pediatric ocular trauma METHODS: The data of 145 cases (145 eyes) with ocular penetrating trauma,hospitalized in Xijing Hospital from January 2012 to December 2016,were collected and retrospectively analyzed.All the data of injury factors and environment,age and gender of patients,lesions,treatment and prognosis were detailed studied.RESULTS: In all the 145 pediatric patients with ocular penetrating trauma,accounted for 8.5% of all the ocular trauma patients,there were 95 cases of male,and 50 of female.Penetrating injuries mainly occurred in age of 3-9.The main injuries of ocular perforating in children were scissors,and sharp objects of wooden and iron.The wound was often located in the cornea or the anterior sclera.Traumatic cataract,vitreous hemorrhage and endophthalmitis were the common complications.The visual acuity was severely damaged,and 90 cases (62.1%) of the children recovered better than 0.1 after effective treatment.CONCLUSION: The visual function of pediatric p0atients was seriously threatened after penetrating injuries.However,the damage of vision and the rate of blindness can be reduced effectively after timely and correct diagnosis and treatment.It is the most important that active and effective prevention in keep children away from penetrating injuries.
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?AIM:To observe the values and changing rules of angle Kappa in corneal refractive surgery under light and dark conditions.?METHODS:Two hundred and thirty-four eyes of 118 patients for corneal refractive surgery were enrolled for this study.Pupil diameters and angle Kappa values under light and dark conditions were measured by Keratron Scout corneal topography.?RESULTS: There were significant differences in pupil diameters between light and dark conditions (P<0.01). More angle Kappa of both eyes distributed in the superior nasal quadrant under light conditions, and more angle Kappa distributed in the superior temporal quadrant under dark conditions.The differences of horizontal and vertical offsets of angle Kappa under two conditions were statistically significant (P<0.01).?CONCLUSION: The changes of pupil diameters in light and dark conditions could affect angle Kappa and then affect the accuracy of corneal refractive surgery centered on angle Kappa.
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To investigate the effect of Chinese medicine raw materials and production technology on quality consistency of Chinese patent medicines with Gegen Qinlian decoction as an example, and establish a suitable method for the quality consistency control of Chinese patent medicines. The results showed that the effect of production technology on the quality consistency was generally not more than 5%, while the effect of raw materials was even more than 30%, indicating that the effect of raw materials was much greater than that of the production technology. In this study, blend technology was used to improve the quality consistency of raw materials. As a result, the difference between the product produced by raw materials and reference groups was less than 5%, thus increasing the quality consistence of finished products. The results showed that under the current circumstances, the main factor affecting the quality consistency of Chinese patent medicines was raw materials, so we shall pay more attention to the quality of Chinese medicine's raw materials. Finally, a blend technology can improve the quality consistency of Chinese patent medicines.
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AIM: To evaluate cell proliferation, apoptosis and migration of human retinal pigment epithelial cells ( RPE) when co - cultured with human marrow mesenchymal stem cells ( hMSCs ) in condition of hypoxia and hyperglycemia so as to explore possible mechanisms of diabetes aggravating choroidal neovascularization ( CNV) preliminarily. METHODS:Both hMSCs and RPE cells were co-cultured in a transwell system. The experiment was divided into four groups: 21% O2 with 5. 56mmol/L glucose ( control group, A ), 21% O2 with 30mmol/L glucose ( hyperglycemia and normoxia group, B ) , 5% O2 with 5.56mmol/L glucose ( normoglycemia and hypoxia group, C ) and 5% O2 with 30mmol/L glucose ( hyperglycemia and hypoxia group, D) . Cell Counting Kit-8 (CCK-8) was used to detect the proliferation of RPE cells in each group at 12, 24 and 48h respectively. Flow cytometry was performed to observe apoptosis of RPE cells at 24h. Additionally, we assessed migration capabilities of RPE via transwell assay under the condition of hyperglycemia and hypoxia by co-culturing of hMSCs.RESULTS:In this co-culturing system, at 12, 24 and 48h, group B (1. 61±0. 41, 1. 80±0. 34;1. 91±0. 35), C (1.34±0. 46, 1. 94±0. 40, 2. 14±0. 41) and D (1. 98±0. 47, 2.26±0.42, 2. 55±0. 40) showed significantly higher proliferation rate than group A (0. 92±0. 45, 1. 27±0. 32, 1.59±0. 41, P0. 05). CONCLUSION:By coexistence with hMSCs, the synergy of hyperglycemia and hypoxia can improve migration and proliferation of RPE cells, and have no effect on apoptosis of RPE cells within short period.
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·AlM: To investigate pathogeny and effects of surgery on paralytic strabismus. · METHODS: A retrospective study was done in 46 patients with paralytic strabismus who underwent squint correction in our hospital from June 2010 to June 2013. Among 26 horizontal strabismus, the cases of extra rectus palsy was 16, internal rectus palsy was 10.Among all20 vertical strabismus, the cases of superior oblique palsy, superior rectus palsy, inferior rectus palsy, double elevator palsy counted for 7, 8, 2 and 3, respectively. Pathogenesis: trauma was 19 cases, followed by 10 cases that the causes could not be identified.Nine was congen ital paralytic strabismus, 8 o ccurred after nose or brain surgery. The surgery methods included rectus muscle recession, rectus muscle resection, partial rectus muscle transposition, Jensen procedure, inferior oblique myectomy and anterior transposition of inferior oblique. Statistical software SPSS10.0 was used in chi-square test between two groups, while the situation of paralysis eye movements improved by two methods in the horizontal strabismus group was compared with t test. · RESULTS: Among all horizontal strabismus the rate of cure, improvement and inefficiency was 20 ( 77%) , 5 ( 19%) and 1 ( 4%) , respectively. Among vertical strabismus the ratio of cure, improvement and inefficiency was 15 (75%), 3 (15%) and 2 (10%).There was no significantly difference between the two groups ( P >0.05 ). The movements of paralytic eyes were improved. Two procedures used in horizontal strabismus, can improve paralysis eye movements were 3.76 ±0.91, 3.72 ±0.84mm, with no significant difference (P=0.93) statistically. · CONCLUSlON: Paralytic strabismus in adults had complicated conditions. Choosing different operation methods in treating paralytic strabismus according to the degree of paralysis can result in satisfactory cosmetically alignment of the eyes and modify head position and diplopia.
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AlM: To evaluate the effect of rigid gas permeable contact lens ( RGP ) in correcting high myopia and astigmatism.METHODS: Forty-one patients ( 65 eyes ) with myopia (-9. 03 ± 6. 19DS, maximum -23. 00DS) and astigmatism (-1. 41 ± 1. 32DC, maximum -5. 50DC) were fitted with RGP after strict routine ophthalmological examination, objective refraction and subjective refraction. All these patients were followed after 1wk, 1, 3mo and half one year.RESULTS:Sixty-five eyes were fitted with RGP (-9. 92± 5. 96DS). RGP base curve ( BC) was majorly located within the range 7. 20 ~8. 25mm. 46. 2% eyes with RGP achieved 1. 0 ( BCVA ) and 80. 1% achieved above 0. 6 ( BCVA) . However, with spectacles, the percent was 28%(1. 0) and 60% (>0. 6), respectively. BCVA of RGP was 0. 81 ± 0. 22, but BCVA with spectacles was 0. 66 ± 0. 28, there was statistical significance (P<0. 01). There were 40 eyes (62%) fitted with RGP whose vision were enhanced more than 1 line, 24 eyes ( 37%) whose vision were not changed and 1 eye (2%) whose vision were dropped 1 line.CONCLUSlON:RGP effectively improves visual acuity of high myopia and astigmatism compared with spectacles.
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· Currently, refresher doctors’training is an important form of continuing medical education in our country, effectively promoting and improving the clinical ability and the service level of practitioners in basic -level medical organization. We combine ophthalmic professional features with refresher doctors’training in practice to explore ophthalmic continuing clinical training specifications.Training on the current status and new changes has been analyzed in order to further improve the training quality. The competent administrative departments and clinical teaching hospital should make full use of its advantages to institutionalize, specialize and standardize the training. We suggest linking the continuing clinical training with job promotion;strengthen core clinical ability and being strict with appraisal system so that after the training the trainees can spread standardized guidelines and technology, alleviating the current medical demand and the difficulties in the reform.
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AIM: To analyze clinical data of hospitalized patients with age - related cataract treated through clinical pathway in our hospital, and to investigate the effectiveness of clinical pathway in standardizing medical behavior, advancing work efficiency, and improving quality of hospital management. METHODS:Data of patients with age-related cataract, who were treated with phacoemulsification combined with intraocular lens implantation in Xi'an North Hospital, were retrospectively analyzed. In clinical pathway group, 220 patients underwent cataract surgery from October 2012 to May 2013 in accordance with clinical pathway. For control group, 213 patients with cataract receiving surgery from October 2010 to June 2011, comply with conventional process. Effect of cataract surgery, average length of hospitalization, average cost of hospitalization, and degree of satisfaction of patients were comprehensive investigated. RESULTS: In 220 patients of clinical pathway group, 209 ( 95. 0%) got improved vision, the days of hospitalization was 4. 5 ± 1. 4d, and the average hospitalized consumption was 4 522. 3 ± 285. 1 Yuan. Whereas, in control group, visual acuity in 202 (94. 8%) out of 213 patients were improved, and the length and cost of hospitalization were 5. 1±1. 7d and 4 647. 7±271. 2 Yuan. The difference of the length and cost of hospitalization between these two groups were significant (P0. 05). CONCLUSION: Practicing of age - related clinical pathway is helpful in standardizing medical heavier, optimizing clinical process, reducing health cost, improving quality of medical care, and providing evidence for hospital management innovation.
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<p><b>BACKGROUND</b>Diabetic macular edema (DME) is a common manifestation of diabetic retinopathy (DR) that forms the main cause of central visual impairment. This study aimed to compare the efficacy and safety of a single intravitreal injection of bevacizumab alone versus bevacizumab combined with triamcinolone acetonide in eyes with diabetic macular edema (DME).</p><p><b>METHODS</b>A total of 40 eyes in 40 Chinese patients (22 male and 18 female) diagnosed with diabetic macular edema were enrolled in this prospective, randomized, consecutive study. Among them, 21 patients in group 1 were treated with intravitreal injection of bevacizumab (1.25 mg/0.05 ml), and the other 19 patients in group 2 accepted intravitreal bavacizumab (1.25 mg/0.05 ml) combined with triamcinolone acetonide (2 mg/0.05 ml). All patients were examined at baseline and followed up at 4, 6 and 12 weeks after the injection. Changes in mean best correct visual acuity (BCVA) using ETDRS chart, central retina thickness (CRT) measured by optical coherence tomography (OCT), and intraocular pressure (IOP) were focused on.</p><p><b>RESULTS</b>In group 1, mean BCVA improved from (41.76 ± 15.59) letters (baseline) to (56.24 ± 18.56) letters, (52.57 ± 12.31) letters and (48.41 ± 17.90) letters at 4, 6 and 12 weeks post-injection, respectively (P = 0.004, P = 0.011 and P = 0.026, respectively). Mean CRT decreased from (525.76 ± 184.10) µm (baseline) to (270.33 ± 202.67)µm, (303.12 ± 168.43) µm and (402.26 ± 196.21) µm, respectively (P = 0.009, P = 0.016 and P = 0.030, respectively). In group 2, mean BCVA improved from (39.89 ± 12.27) letters (baseline) to (55.31 ± 19.27) letters, (51.25 ± 13.48) letters and (46.97 ± 16.23) letters at 4, 6 and 12 weeks after injection, respectively (P = 0.003, P = 0.010 and P = 0.027, respectively). Mean CRT decreased from (554.50 ± 169.05) µm (baseline) to (292.76 ± 196.05) µm, (323.46 ± 164.05) µm and (426.38 ± 169.05) µm, respectively (P = 0.009, P = 0.014 and P = 0.028, respectively). However, there was no significant difference between these two groups with regard to mean BCVA (F = 1.602, P = 0.216) and CRT (F = 0.412, P = 0.526). At 12 weeks after the injection, 11 of the patients in group 1 and nine patients in group 2 appeared recurrent macular edema and needed repeat injections. There was one patient in group 2 appeared transient intraocular pressure increases.</p><p><b>CONCLUSIONS</b>Intravitreal injection of bevacizumab combined with/without triamcinolone acetonide had a beneficial effect on DME. However, the significant effect was not permanent. Our results showed that no significant differences were detected between intravitreal bevacizumab combined with/without triamcinolone acetonide for the eyes with diabetic macular edema in Chinese patients.</p>
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Adult , Aged , Female , Humans , Male , Middle Aged , Antibodies, Monoclonal , Therapeutic Uses , Antibodies, Monoclonal, Humanized , Bevacizumab , Diabetic Retinopathy , Drug Therapy , Immunosuppressive Agents , Therapeutic Uses , Intravitreal Injections , Macular Edema , Drug Therapy , Treatment Outcome , Triamcinolone Acetonide , Therapeutic UsesABSTRACT
Background The underlying mechanism of choroidal neovascularization(CNV) is multifactorial and complex.Focal adhesion kinase(FAK) plays a crucial role in controlling essential cellular processes and influencing distinct steps of the angiogenic response.But to our knowledge,seldom study on the effect of FAK on CNV formation has been reported previously.Objective In this study,the effect of several CNV risk factors on the expression of FAK in cultured retinal pigment epithelium(RPE) cells was investigated to illuminate effect of FAK on CNV.Methods Human RPE cells were isolated from donor eyes and exposed to H2O2,swallow of outer segment of photoreceptors(POS) and extracellular matrix(ECM) separately with the treating as follows:RPE cells were co-cultured with 10,20,50 and 100μmol/L H2O2 for 20 days;POS(1×106/ml) were co-cultivated with RPE cells for 20 days(setting control group,POS group,hypoxia group with 200μmol/L CoCl2,and POS+hyoxia group);RPE cells were cultured on the plates coated with 100mg/L fibronectin(FN),laminin(LN) or collagen typeⅠfor 30minutes or 1 hour.The expression of FAK and pFAK in RPE cells were examined by Western blot analysis.Results FAK was highly expressed in the 20μmol/L and 50μmol/L H2O2 groups compared with control group(P＜0.01);while he expression level of pFAK was reduced after treated with H2O2 in comparison with the control group(P＜0.01).After cultured with POS for 20 days,the undigested lysosome could be observed in RPE cells.The expressions of FAK and pFAK in RPE cells were not significantly changed between control group and POS groups(P＞0.05),but those in hypoxia group were significantly up-regulated in comparison with control group(P＜0.01).Compared with the hypoxia group,the expression amount of pFAK was elevated in POS+hyoxia group(P＜0.01).In comparison with control group,the increased pFAK expression was seen in FN,LN and collagen typeⅠtreating for 1-hour groups(P＜0.05,P＜0.01).Conclusion FAK pathway participates in several CNV-initiated signaling,such as H2O2,POS and ECM,in cultured RPE cells.It is reasonable to believe that FAK potentially plays an important role in CNV-dependent disorder.
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Age-related macular degeneration(AMD)is a kind of degenerative diseases with complex pathogenesis and stimulation of multiple factors.It has become one of the major diseases causing-blindness in the elderly population in China.Recently,some epidemiological findings demonstrated that diabetes mellitus possibly is one of risk factors for AMD,and this will offers a new approach for the prevention and treatment of AMD.Thus,it is very important for US to strengthen the research of mechanism of AMD impacted by diabetes mellitus,pay more attention to the progress of AMD,search for a scientific and rational therapeutic way of improving the prognosis and elevate the quality of life in the patients with diabetes mellitus.
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Background Exophthalmos caused by brain-related diseases will result in the serious outcome if treated improperly.It will be helpful for the diagnosis of the disease correctly when signs and symptoms are taken into consideration.Objective This study was to analyze the cause and clinical manifestations of exophthalmos due to brain-related diseases.Methods The elinical data from 38 patients with exophthalmos caused by brain-related diseases was collected and analyzed retrospectively.The sex,age,cause,exophthalmos range,symptom and sign of patients were considered. Results The gender of 38 patients was 21 males(55.26％)and 17 females(44.74％),aged from 16 to 71 years old with the average age 37.21.Four types of brain-related diseases were associated with the exophthalmos of eyeballs,including benign tumor 65.79％(25/38)containing the meningioma 60.53％(23/38),chordoma 5.26％(2/38)；malignant tumor 5.26％(2/38)containing the malignant meningioma 2.63％(1/38),choroid tong one cases of papillary carcinoma 2.63％(1/38)；carotid-cavernous fistula 26.32％(10/38)；meningoencephalocele 2.63％(1/38).Exophthaimos ranged from 18 to 35 mm in the patients with the average value of 22.17 mm.In all of the 38 patients,the right eyes were 36.84％(14/38),and left eyes were 55.26％(14/38)and bilateral eyes 7.89％(3/38).Accompanying signs and symptoms of meningioma included long-term headache (65.22％),nausea and vomiting(21.74％).declined vision(17.39％),elevated intraocular pressure,visual field shrink and loss,etc..Accompanying signs and symptoms of carotid cavernous fistula were loss of vision,pulsatile exophthalmos,noise over the orbit,ocular limitation of movement,eyelid edema(80％),bulbar conjunctival congestion,episodes of eyelid,diplopia(80％),headache(60％). Conclusion Some brain diseases are often accompanied by exophthalmos.Exophthaimos can provide useful clues to the diagnosis of brain diseases.
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·AIM:To present a case of late onset bilateral keratectasis after laser in situ keratomileusis (LASIK) for myopia with rigid gas-permeable contact lenses with a brief review of literature on this subject.·METHODS:A 27-year-old woman underwent bilateral uneventful LASIK for moderate myopia. Preoperative cycloplegic refractions were -5.50/-0.50×50° right eye (OD) and - 4.50/-1.00×15° left eye (OS).Corneal pachymetry was 526μm OD and 541μm OS, Preoperative corneal topography was normal and did not reveal any keratoconus or forme fruste keratoconus.Following the creation of flaps with 160μm plates,ablations of 102μm OD and 86μm OS were performed,estimated to leave residual stromal beds of 264μm OD and 295μm OS.·RESULTS:Twenty-nine months postoperatively,the patient developed bilateral inferior keratectasia of -12.50/-4.00×160° OD and -6.00/- 4.25×125° OS.Visual acuity was reduced in both eyes;the central cornea had steepened; and pachymetry showed central corneal thinning.Keratectasia was diagnosed,and rigid contact lenses were fitted.Three years later,the patient achieved satisfactory visual acuity and all-day lens wear with minimal complications.·CONCLUSION:Late keratectasia may follow LASIK for low to moderate myopia despite a thorough preoperative work-up.Rigid contact lenses can offer a safe,reversible option for improving visual acuity in such patients by delaying or avoiding the need for intracorneal ring segments implanting or penetrating keratoplasty.
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● AIM: To investigate the role of advanced glycation endproducts (AGEs) in the pathogenesis of age-related macular degeneration (AMD).● METHODS: Bovine choroidal endothelial cells (CEC:)were isolated by the modified protocol using lycopersicon esculentum agglutinin coated Dynabeads, and identiffed by immunocytochemical staining with anti-Factor Ⅷ antibody and uptaking of dil-acetylated low-density lipoprotein (dil-ac-LDL). AGEs were prepared by incubating 50g/L bovine serum albumin and 150g/L glucose at 37℃ for 6wk, which were characterized by dot blot assay with anti-AGEs antibody. CEC proliferation was evaluated using 3,(4,5-dimethylthiazol-2-yl)-2,5- diphenyl tetrazolium bromide (MTT) assay, and tube formation in CEC was determined by a Vitrogen system.● RESULTS: More than 90% of the cultured cells were positive to Factor V immunostaining and had the ability to uptake dil-ac-LDL, which were the features of endothelial cells. AGEs we prepared were affinitive to anti-AGEs antibody. After treatment with AGEs for a time course of 3d, CEC proliferation was significantly increased in a dose-dependent manner by AGEs at concentrations between 62.5 and 500mg/L. The cytokine,basic fibroblast growth factor (bFGF), enhanced strongly tube-like structure formation in CEC to 124% (P＜0.05)above that of untreated controls. In this condition, AGEs at the concentrations of 500 and 50mg/L showed no effect on CEC tube formation (P＞0.05).● CONCLUSION: The present study demonstrated that CEC proliferation was increased by AGEs, however, regarding there was no statistically effect on CEC tube formation. These findings confirm and extend that AGEs could be a potential initiator in the pathogenesis of choroidal neovascularization in exudative AMD, at least in part, through enhancement of CEC proliferation.
ABSTRACT
The research progress on Chinese medicine plant resources with pesticide activities, the active components and their reaction mechanism as well as the application and prospect were reviewed in this paper. Some proposals on the exploitation of traditional Chinese medicine plant origin pesticide were given. It is suggested to found compounds with pesticide activities from heat clearing and toxic clearing medicinal plants.