Blood-retinal barrier as a converging pivot in understanding the initiation and development of retinal diseases / 中华医学杂志(英文版)

Clinical ophthalmologists consider each retinal disease as a completely unique entity. However, various retinal diseases, such as uveitis, age-related macular degeneration, diabetic retinopathy, and primary open-angle glaucoma, share a number of common pathogenetic pathways. Whether a retinal disease initiates from direct injury to the blood-retinal barrier (BRB) or a defect/injury to retinal neurons or glia that impairs the BRB secondarily, the BRB is a pivotal point in determining the prognosis as self-limiting and recovering, or developing and progressing to a clinical phenotype. The present review summarizes our current knowledge on the physiology and cellular and molecular pathology of the BRB, which underlies its pivotal role in the initiation and development of common retinal diseases.

Analysis of evaluation results of malaria elimination in Jiujiang City / 中国血吸虫病防治杂志

Objective To analyze the evaluation results of malaria elimination and summarize the experience in Jiujiang City, so as to provide the evidence for formulating the surveillance work plan post-malaria elimination. Methods According to the requirements and arrangements of Jiangxi Eliminating Malaria Action Plan (2010 – 2020), the evaluation of malaria elimination was completed in all 13 counties (cites and districts) of Jiujiang City from 2013 to 2016, and the data were collected and analyzed. Results In Jiujiang City, the last local malaria case was reported in 2008. From 2010 to 2016, there were 20 imported malaria cases reported, including 12 cases of falciparum malaria, 7 cases of vivax malaria, and 1 case of mixed infection. Totally 67 501 fever patients were tested for Plasmodium and 13 cases were positive, with the positive rate of 0.02%. The comprehensive evaluation scores were between 88.75 and 98.15 in all the 13 counties (cities and districts), which meant they all reached the evaluative criteria. Conclusion All 13 counties (cities and districts) of Jiujiang City have passed the city level evaluative criteria of malaria elimination, and the key work should be the prevention and surveillance of imported malaria in the future.

Analysis of evaluation results of malaria elimination in Jiujiang City / 中国血吸虫病防治杂志

Objective To analyze the evaluation results of malaria elimination and summarize the experience in Jiujiang City, so as to provide the evidence for formulating the surveillance work plan post-malaria elimination. Methods According to the requirements and arrangements of Jiangxi Eliminating Malaria Action Plan (2010 – 2020), the evaluation of malaria elimination was completed in all 13 counties (cites and districts) of Jiujiang City from 2013 to 2016, and the data were collected and analyzed. Results In Jiujiang City, the last local malaria case was reported in 2008. From 2010 to 2016, there were 20 imported malaria cases reported, including 12 cases of falciparum malaria, 7 cases of vivax malaria, and 1 case of mixed infection. Totally 67 501 fever patients were tested for Plasmodium and 13 cases were positive, with the positive rate of 0.02%. The comprehensive evaluation scores were between 88.75 and 98.15 in all the 13 counties (cities and districts), which meant they all reached the evaluative criteria. Conclusion All 13 counties (cities and districts) of Jiujiang City have passed the city level evaluative criteria of malaria elimination, and the key work should be the prevention and surveillance of imported malaria in the future.

Transitions of the Understanding and Definition of Primary Glaucoma / 中华医学杂志(英文版)

Objective@#In previous decades, glaucoma has been primarily attributed to elevated intraocular pressure (IOP), but this has gradually been replaced by the development of optic neuropathy as the central concept of glaucoma in developed countries. However, there still remain strong controversies in the definition of glaucoma in China. In this current review, we are going to discuss these controversies and elaborate on the historical transitions of the definition of glaucoma both in China and developed countries. Furthermore, we will briefly describe the "ocular-cranial pressure gradient" theory and discuss the relationship between glaucoma and degenerative diseases of the central nervous system (CNS) in order to show the complex pathogenesis of glaucoma and the importance for the modification to the definition of glaucoma.@*Data Sources@#We performed a comprehensive search in both PubMed and SinoMed using the following keywords: (a) "primary glaucoma" and "guideline," (b) "ocular-cranial pressure gradient," and (c) "glaucoma," "Alzheimer's disease," and "Parkinson's disease." The literature search included the related articles with no restrictions on publication date.@*Study Selection@#The primary references were Chinese and English articles including (a) original guidelines and expert consensuses of primary glaucoma, (b) reviews focusing on the differences between various versions of these guidelines and consensuses, and (c) papers about ocular-cranial pressure gradient theory and the relationship between glaucoma and CNS degenerative diseases.@*Results@#The definitions and classifications of both primary open-angle glaucoma and primary angle-closure glaucoma differ between Chinese glaucoma consensuses and international primary glaucoma guidelines. Chinese definitions and classifications put more emphasis on the IOP, while international guidelines put more emphasis on the presence of optic neuropathy. The ocular-cranial pressure gradient theory and the research on the relationship between glaucoma and CNS degenerative diseases have provided new directions for exploring the pathogenesis of glaucoma.@*Conclusions@#As regards the definition and classification of primary glaucoma, we find that there are still some discrepancies between Chinese expert consensuses and international guidelines. Glaucoma is a disease with complex etiologies, while its common characteristic is a specific optic neuropathy. The current definition and understanding of glaucoma is an ongoing and evolving process, reflecting our latest available evidence on its pathogenesis. Chinese ophthalmology community may need to update our guidelines, accommodating these latest developments.

Expression changes of Notch-related genes during the differentiation of human mesenchymal stem cells into neurons / 生理学报

The Notch signaling pathway has been implicated in the regulation of cell-fate decisions such as differentiation of embryo stem cells and neural stem cells into neurons. We cultured human mesenchymal stem cells (hMSCs) in vitro and induced hMSCs to differentiate into neural cells by beta-mercaptoethanol (beta-ME), DMSO and 3-tert-butyl-4-hydroxyanisole (BHA). Immunocytochemistry was utilized to detect neuron-specific enolase (NSE) and Nissl body, and flow cytometry was used to determine cell growth phases. The expressions of signal molecules involved in the Notch pathway such as Notch1, Jagged 1 (JAG1), presenilin 1 (PS1) and hairy and enhancer of split 1(HES1) were observed by RT-PCR and immunofluorescent techniques. The results were as follows: (1) Before induction, the percentage of hMSCs at G(0)/G(1) was 58.5%, and the percentage at S+G(2)/M was 41.5%. After induction, the percentage of hMSCs at G(0)/G(1) increased to 73.1%, 76.2% and 78.1%, respectively on days 2, 4 and 6, and the percentage at S+G(2)/M decreased to 26.8%, 24.8% and 21.9%, respectively; The percentage of NSE-positive cells reached (77+/-0.35) %; Nisslos staining was positive in cytoplasm. (2) Notch1 and JAG1 were both expressed in hMSCs before and after induction, but the mRNA expressions of both Notch1 and JAG1, detected by RT-PCR, decreased obviously after induction(P<0.05). Notch1 mRNA/beta-actin was 1.157, 0.815, 0.756 and 0.570, and JAG1 mRNA/beta-actin was 0.437, 0.350, 0.314 and 0.362, respectively, on days 0, 2, 4 and 6 after induction. The Notch pathway activation participant PS1 mRNA and Notch pathway target gene HES1 mRNA also decreased apparently after induction (P<0.05), and their mRNA/beta-actin was 0.990, 0.449, 0.441, 0.454 and 0.370, 0.256, 0.266, 0.240 on days 0, 2, 4 and 6, respectively. These observations indicate that the expressions of Notch signal molecules were suppressed when hMSCs were induced to differentiate into neural cells. Based on these findings, we propose that low level of Notch signaling activation may contribute to neural cell differentiation.