Identification of the Microbial Transformation Products of Secoisolariciresinol Using an Untargeted Metabolomics Approach and Evaluation of the Osteogenic Activities of the Metabolites.

Secoisolariciresinol (SECO) is one of the major lignans occurring in various grains, seeds, fruits, and vegetables. The gut microbiota plays an important role in the biotransformation of dietary lignans into enterolignans, which might exhibit more potent bioactivities than the precursor lignans. This study aimed to identify, synthesize, and evaluate the microbial metabolites of SECO and to develop efficient lead compounds from the metabolites for the treatment of osteoporosis. SECO was fermented with human gut microbiota in anaerobic or micro-aerobic environments at different time points. Samples derived from microbial transformation were analyzed using an untargeted metabolomics approach for metabolite identification. Nine metabolites were identified and synthesized. Their effects on cell viability, osteoblastic differentiation, and gene expression were examined. The results showed that five of the microbial metabolites exerted potential osteogenic effects similar to those of SECO or better. The results suggested that the enterolignans might account for the osteoporotic effects of SECO in vivo. Thus, the presence of the gut microbiota could offer a good way to form diverse enterolignans with bone-protective effects. The current study improves our understanding of the microbial transformation products of SECO and provides new approaches for new candidate identification in the treatment of osteoporosis.

Reconfigurable reflective multifunction OAM metasurface based on spin-decoupling.

This Letter develops a spin-decoupled reconfigurable reflective orbital angular momentum (OAM) metasurface (MTS). The reconfigurability is realized by switching the feed among left-hand circular polarization (LHCP), right-hand circular polarization (RHCP), and linear polarization (LP) incidences, and the reconfigurable design principle is provided. This Letter also proposes a design method for the desired energy ratio between the co-polarized and cross-polarized beams. Compared with published multifunction MTSs, the designed MTSs have the following advantages: multi-polarizations, arbitrary beam numbers and modes, composite waveform (pencil and OAM beams), high aperture efficiency (21.1%, 14.6%, 6.63% for RHCP, LP, and LHCP incidences, respectively), high purity (above 92.41%), required energy distribution ratio, and reconfigurability. The MTSs have potential prospects in high-capacity wireless communications.

Low-density point eating algorithm for surface reconstruction from dense scans.

We present a low-density point eating algorithm for surface reconstruction from dense scans. First, the density map for each scan is estimated and the boundary densities are down-weighted. Subsequently, the poorly scanned low-density overlapping points are eaten up based on a user-specified threshold. Finally, the overlapping areas are thinned by using the moving least-squares operator and the homogeneous points are weighted averaged. The new algorithm can extract smooth but detailed point set surfaces that are as close as possible to the ground truth. The good performance of the new algorithm is demonstrated by comparison with several advanced surface reconstruction algorithms.

The long-term spatio-temporal trends in burden and attributable risk factors of major depressive disorder at global, regional and national levels during 1990-2019: a systematic analysis for GBD 2019.

AIMS: Caused by multiple risk factors, heavy burden of major depressive disorder (MDD) poses serious challenges to public health worldwide over the past 30 years. Yet the burden and attributable risk factors of MDD were not systematically known. We aimed to reveal the long-term spatio-temporal trends in the burden and attributable risk factors of MDD at global, regional and national levels during 1990-2019. METHODS: We obtained MDD and attributable risk factors data from Global Burden of Disease Study 2019. We used joinpoint regression model to assess the temporal trend in MDD burden, and age-period-cohort model to measure the effects of age, period and birth cohort on MDD incidence rate. We utilized population attributable fractions (PAFs) to estimate the specific proportions of MDD burden attributed to given risk factors. RESULTS: During 1990-2019, the global number of MDD incident cases, prevalent cases and disability-adjusted life years (DALYs) increased by 59.10%, 59.57% and 58.57%, respectively. Whereas the global age-standardized incidence rate (ASIR), age-standardized prevalence rate (ASPR) and age-standardized DALYs rate (ASDR) of MDD decreased during 1990-2019. The ASIR, ASPR and ASDR in women were 1.62, 1.62 and 1.60 times as that in men in 2019, respectively. The highest age-specific incidence, prevalence and DALYs rate occurred at the age of 60-64 in women, and at the age of 75-84 in men, but the maximum increasing trends in these age-specific rates occurred at the age of 5-9. Population living during 2000-2004 had higher risk of MDD. MDD burden varied by socio-demographic index (SDI), regions and nations. In 2019, low-SDI region, Central sub-Saharan Africa and Uganda had the highest ASIR, ASPR and ASDR. The global PAFs of intimate partner violence (IPV), childhood sexual abuse (CSA) and bullying victimization (BV) were 8.43%, 5.46% and 4.86% in 2019, respectively. CONCLUSIONS: Over the past 30 years, the global ASIR, ASPR and ASDR of MDD had decreased trends, while the burden of MDD was still serious, and multiple disparities in MDD burden remarkably existed. Women, elderly and populations living during 2000-2004 and in low-SDI regions, had more severe burden of MDD. Children were more susceptible to MDD. Up to 18.75% of global MDD burden would be eliminated through early preventing against IPV, CSA and BV. Tailored strategies-and-measures in different regions and demographic groups based on findings in this studywould be urgently needed to eliminate the impacts of modifiable risk factors on MDD, and then mitigate the burden of MDD.

[Think highly of the diagnose and therapy of ocular pathological changes in the HIV infected and AIDS patients].

Acquired immune deficiency syndrome (AIDS) is a kind of fatal disease which involve multiple organs and the public health of global intention. The incidence rate in China is escalating obviously. Currently there is lack of large samples and long-term systematic observations of ocular pathological changes in the human immunodeficiency virus (HIV) infected and AIDS patients. Diagnostic errors and missed diagnosis still exist in hospitals, even in some advanced hospitals. They delay the therapy of patients, also easily result in hospital acquired infections. It is notable that there is insufficient attention to preoperative test of anti-HIV in some hospitals, especially in outpatient surgeries. Therefore potential iatrogenic infection risks are hidden. Some clinical doctors are afraid of AIDS patients, therefore they are lack of subjective initiative to comprehensively examination and treatment the patients. For the past few years, highly active antiretroviral therapy is widely used, AIDS related morbidity and mortality is significantly reduced, and the prevalence rate of ocular complications decreased from 55% to 95%. But due to the HIV/AIDS patient volume increased year by year, and the survival rate raised, prolonged survival, results in the increase of the absolute number of patients with ocular complications. Therefore it is critical to pay attention to the HIV/AIDS ocular lesions in the diagnosis and treatment of iatrogenic infection.

[Current status and progress of fungal endophthalmitis treatment].

Fungal endophthalmitis is a devastating infectious disease, with a poor visual prognosis and even possibility of eyeball enucleated. In recent years, the incidence of fungal endophthalmitis remarkably increased due to widely use of broad-spectrum antibiotics and corticosteroid hormone. This pose a challenge to ophthalmologists and their capacity of treating fungal endophthalmitis need to be improved. It is necessary to introduce the present status and progress in fungal endophthalmitis treatment focus on medications, surgery and its etiological examination, especially the use of newer antifungal agents, including voriconazole and liposomal amphotericin B.

[Vitreal surgery and etiological diagnosis of bacterial endophthalmitis].

OBJECTIVE: To evaluate the clinical effects of vitreal surgery and the importance of etiological diagnosis in the treatment for bacterial endophthalmitis. METHODS: Retrospective series case study. 20 cases (20 eyes) of bacterial endophthalmitis that were treated in Peking Union Hospital were enrolled. 14 eyes were post-traumatic endophthalmitis, and 6 eyes were postoperative endophthalmitis. Twenty cases of aged 3 to 83 years [mean (40.5 ± 23.9) years] were enrolled, including 12 male and 8 female patients. Pre-operative visual acuity: 2 cases were able to count fingers, 6 cases were able to perform hand movement, 11 cases had light perception, light projection were uncertain in all cases, and there was no light perception in 1 case. Hypopyon was seen in 13 eyes. Severe anterior chamber inflammatory reaction was seen in the other 7 eyes. The fundus could not be observed in all 20 eyes. B-Scan ultrasound examination indicated that all 20 eyes displayed moderate to severe vitreous opacity; proliferation and organization were apparent in 12 eyes, and retinal detachment in 2 eyes. Vitrectomy and intravitreal injection of antibiotics were performed in 18 eyes, and only intravitreal injection of antibiotics was administered in the other 2 eyes. At the beginning of operation, vitreous fluids were smeared and Gram stained. To eyes that showed a positive result in Gram staining, 1 mg of Vancomycin was injected into the vitreous cavity or added in the perfusion fluid (balanced salt solution, BSS) in the eyes. To eyes that showed a negative result in Gram staining, 2 mg or 4 mg of Ceftazidime was injected into the vitreous cavity or added in the perfusion fluid (BSS) in the eyes, respectively. Additionally, we examined the vitreous specimens and performed drug susceptibility testing of the bacteria cultured from the specimens. The antibiotics that the bacteria were susceptible to were chosen according to the drug sensitivity tests. The follow-up period is from 1 to 102 months (average 16.6 months). RESULTS: Thirteen eyes presented with a positive Gram staining result, and 3 eyes presented a negative result; the other 4 eyes were not infected. Bacteria were cultured in 15 eyes. The detection rate of pathogen was 75%. The result for 11 eyes was consistent with the smear results. The bacteria detected were Staphylococcus aureus in 3 eyes, Staphylococcus epidermidis in 3 eyes, and Bacillus spp in 2 eyes. Streptococcus pneumoniae, Streptococcus mitis, Plesiomonas, Pseudomonas cepacia, Klebsiella oxytoca, Loffi Acinetobacter and Pseudomonas fluorescens were detected in 1 eye. The remaining 5 eyes did not have bacterial growth. The intraocular infection of all 20 eyes was controlled, and the intraocular inflammation was relieved. The visual acuity was significantly elevated. Postoperative visual acuity achieved were ≥ 0.3 in 4 eyes, 0.1 to 0.2 in 4 eyes, 0.02 to 0.09 in 6 eyes, CF in 2 eyes, HM in 3 eyes and LP in 1 eye. The retinas of 17 eyes were normal, but recurrent retinal detachment occurred in the other 3 eyes, postoperatively. CONCLUSIONS: Vitrectomy combined with antibiotics and intravitreal injection of antibiotics were an effective treatment of bacterial endophthalmitis. We obtained the vitreous fluid smears at the beginning of surgery to quickly and accurately obtain etiological diagnoses by Gram staining. It is crucial to use etiological diagnosis to choose the susceptible antibiotics.

[Fundus manifestation and treatment of Takayasu's arteritis].

OBJECTIVE: To evaluate the fundus manifestation and treatment of Takayasu's arteritis. METHODS: Retrospective case series was taken to study the clinical data of 15 patients (30 eyes) diagnosed with Takayasu's arteritis at Peking Union Medical College Hospital from 1992 to 2010. Examinations included visual acuity, slit-lamp, fundus, fundus fluorescein angiography (FFA), large vascular ultrasound, digital subtraction angiography (DSA), erythrocyte sedimentation rate (ESR) and reactive protein C (CRP). All patients were given systemic corticosteroids, immunosuppressive agents and anticoagulants. Three patients (4 eyes) received retinal photocoagulation, and 1 patient (1 eye) received vitrectomy combined with silicone oil tamponade. RESULTS: Fifteen cases aged 13 - 49 years [mean (33.6 ± 11.1) years] were enrolled, including 2 male and 13 female patients. Two patients recognized by initial presentation of impaired vision prior to the diagnosis of Takayasu's arteritis. Visual acuity: light perception -0.05, 6 eyes; 0.1 - 0.5, 4 eyes; 0.6 - 1.0, 5 eyes; and above 1.0, 15 eyes. The fundus examination revealed chronic ischemic retinopathy in 16 eyes characterized by microaneurysms, cotton-wool spots and peripapillary arteriovenous anastomosis, and complicated by vitreous hemorrhage, retinal detachment and proliferative retinopathy at the late stage. There was hypertensive retinopathy in 14 eyes with features of narrow retinal artery, arteriovenous crossing signs and retinal hemorrhage. FFA showed prolonged arm-to-retina circulation time and retinal circulation time, microaneurysms and neovasculature. Six cases were classified as brachiocephalic arteritis, and 9 patients belonged to extensive arteritis. ESR increased in 9 patients and CRP elevated in 5 patients. Capillary non-perfusion areas in 4 eyes subsided after retinal photocoagulation, and retina reattached in 1 eye after vitrectomy with visual acuity improved from light perception to count finger. CONCLUSIONS: Fundus manifestation of Takayasu's arteritis is usually characterized by chronic ischemic retinopathy and hypertensive retinopathy, and complications such as vitreous hemorrhage, retinal detachment and proliferative retinopathy occur at advanced stage. The first symptom in some patients can be impaired vision. The prognosis could be improved if ophthalmologists know fundus characteristics of Takayasu's arteritis and give timely and correct diagnosis and treatment.

Microbial spectrum and risk factors of endogenous endophthalmitis in a tertiary center of Northern China.

AIM: To study the clinical features, microbial spectrum, associated factors and prognosis of endogenous endophthalmitis (EE) in a group of Chinese patients. METHODS: The medical records from 32 eyes of 29 patients diagnosed with EE in Peking Union Medical College Hospital from January 2009 to October 2019 were reviewed. RESULTS: The initial visual acuity (VA) of 30 eyes in this study was worse than 20/400. Twenty-three eyes were diagnosed with fungal endophthalmitis and nine with bacterial endophthalmitis. The most common fungal and bacterial isolates were Candida and Klebsiella pneumoniae, respectively. Several rare fungi and bacteria species were also isolated from our patients, including Cryptococcus, Paecilomyces, Brucella, and Bacillus licheniformis. The leading risk factor for EE was diabetes. The most common extraocular infection locus was genitourinary tract. Vitrectomy was performed on twenty-nine eyes. Eight eyes achieved final VA of 20/400 or better. EE caused by Candida had a better prognosis. CONCLUSION: The visual outcome of EE is based on pathogens and prompt intervention. Early vitrectomy and antimicrobial treatment are beneficial for EE.

[Ocular toxicity associated with drugs].

The clinical manifestation of ocular toxicity associated with drugs are various. The ocular toxic manifestations and the degree of impairment are different due to the variety, dose, and routes of exposure and so on. It is difficult to diagnose the cause of the toxicity. If we can't find the toxic factor immediately, stop the damage to the eyes, and treat in time, the patient's vision will be impaired or even lose. This article reviews ocular toxicity caused by drugs, including the variety of drugs, clinical manifestations, etiopathogenesis, diagnosis, treatment and prevention.

Clinical features and treatment outcomes of intraocular lymphoma: a single-center experience in China.

AIM: To investigate the clinical manifestations, diagnostic approaches, treatments, and outcomes of intraocular lymphoma. METHODS: In this retrospective study, 16 patients (28 eyes) with intraocular lymphoma were recruited in the Department of Ophthalmology, Peking Union Medical College Hospital, from 2004 to 2019. All patients underwent comprehensive ophthalmic examinations. Vitreous specimens of 13 patients were sent for cytopathology examination and other adjunctive diagnostic procedures. Three patients were diagnosed with intraocular lymphoma according to analysis of the histopathological results of systemic lymphoma by one clinician. Twenty-three eyes were treated with intravitreal administration of methotrexate, 4 eyes could not receive ocular treatment due to life-threatening lymphoma, and 1 eye did not require ocular treatment because the fundus lesions regressed after systematic chemotherapy. RESULTS: In 28 eyes, 25 eyes were diagnosed with vitreoretinal lymphoma, and 3 eyes were diagnosed with ciliary body lymphoma, all of which were non-Hodgkin diffuse large B cell lymphomas. The final visual acuity improved in 15 eyes (54%), remained unchanged in 5 eyes (18%), and decreased in 8 eyes (29%). Anterior segment inflammation disappeared or reduced in 8 and 5 eyes, respectively; and 15 eyes had no anterior segment reaction. Twenty eyes had mild vitreous opacity, 1 eye had mild vitritis, and 7 eyes had pars plana vitrectomy combined with silicone oil tamponade. Fundus lesions disappeared in 9 eyes and were relieved in 5 eyes; 4 eyes showed no changes, and the remaining 10 eyes' fundus were normal. CONCLUSION: The clinical manifestations of intraocular lymphoma are diverse, and the misdiagnosis rate is high. Cytopathological analysis of vitreous is one of the gold standards for the diagnosis. Immunohistochemistry, gene rearrangement and flow cytometric immunophenotypic analysis can improve the diagnostic rate. Ocular chemotherapy or radiotherapy regimens may preserve visual acuity, and a multidisciplinary team can provide individualized treatment for the patients.

[Expressions of collagen , matrix metalloproteases-2, and tissue inhibitor of matrix metalloproteinase-2 in the posterior sclera of newborn guinea pigs with negative lens-defocused myopia].

OBJECTIVE: To observe the expressions of the collagen , matrix metalloproteases-2 (MMP-2), and tissue inhibitor of matrix metalloproteinase-2 (TIMP-2) in the posterior sclera of newborn guinea pigs with negative lens-defocused myopia. METHODS: Newborn guinea pigs were monocularly defocused by -10D lens. After 4 weeks of defocus, the eyes were removed to provide posterior scleral samples for detection. Expression of collagen was detected by immunohistochemistry on frozen sections of guinea pig sclera, and the protein levels of MMP-2 and TIMP-2 were evaluated by Western blot. RESULTS: Immunohistochemical analysis indicated that the expressions of collagen and TIMP-2 were significantly lower and the expression of MMP-2 was significantly higher in the posterior sclera in the defocused eyes than in the contralateral eyes (all P < 0.01). However, all these indicators were not significantly different between the contralateral eyes and normal control eyes (all P > 0.05). In the defocused animals, the refraction of defocused eyes was positively correlated with the expression levels of collagen (r = 0.79, P < 0.01) and TIMP-2 (r = 0.74, P < 0.05) and was negatively correlated with the expression level of MMP-2 (r = -0.78, P < 0.01) in posterior sclera. CONCLUSION: Alteration of extracellular matrix in the posterior sclera, probably participated by MMP-2, may exist during the development of defocus-induced myopia.

[Present status and advances in pharmacotherapy for cytomegalovirus retinitis associated with acquired immunodeficiency syndrome].

Cytomegalovirus retinitis has been the most common opportunistic infection and leading cause of visual loss in AIDS patients. There are five drugs approved by the Food and Drug Administration in the USA for the treatment of cytomegalovirus retinitis: ganciclovir, foscarnet/phosphonoformic acid, valganciclovir, cidofovir and formivirsen. Progress has been made in the treatment of cytomegalovirus retinitis. Nowadays, maribavir, monoclonal antibody MSL-109, cyclopropavir and BAY 38-4766 are entering clinical trials. This review summarizes present status and advances in pharmacotherapy for cytomegalovirus retinitis in AIDS.

Vascular endothelial growth factor concentration in vitreous humor of patients with severe proliferative diabetic retinopathy after intravitreal injection of conbercept as an adjunctive therapy for vitrectomy.

BACKGROUND: Proliferative diabetic retinopathy (PDR) is a progressive stage of diabetic retinopathy featured by the formation of neovascular and proliferative membrane. Vascular endothelial growth factor (VEGF) acts as a pivot factor in the development of neovascularization. This study was to investigate the changes of intravitreal VEGF concentrations of severe PDR after intravitreal injection of conbercept (IVC) and its potential advantages to the following vitrectomy. METHODS: This was a prospective, interventional, randomized controlled study. Sixty eyes (60 patients) with severe PDR and 20 eyes from 20 patients with rhegmatogenous retinal detachment complicated with proliferative vitreoretinopathy were enrolled in this study. PDR eyes were randomly assigned to three groups by sortation randomization method with 20 eyes in each based on the interval of preoperative IVC (group A: 7 days, group B: 14 days, group C: non-IVC). Another 20 eyes without diabetes were enrolled as the non-diabetic control group (group D), receiving PPV directly. Vitreous specimens of all 80 patients were collected and evaluated afterwards. The intravitreal VEGF concentration of the four groups, and the total surgical time and the intraoperative bleeding rate of the PDR groups were recorded. RESULTS: The mean intravitreal VEGF concentrations of groups A-D were 66.6 ±â€Š43.3, 93.1 ±â€Š52.3, 161.4 ±â€Š106.1 and 1.8 ±â€Š1.2 pg/mL, respectively. It increased significantly in PDR patients (groups A, B and C) (P = 0.002, <0.001, and <0.001, respectively). PDR patients with preoperative IVC (groups A and B) presented significantly lower VEGF concentrations (P < 0.001 and 0.001), intraoperative bleeding rates (P = 0.004) and total surgical time (P < 0.001, P = 0.003) compared with group C. No statistical differences were presented between groups A and B on the three parameters. CONCLUSION: Seven days and 14 days of preoperative IVC are equally efficient and safe for the vitrectomy of severe PDR patients through decreasing vitreous VEGF concentrations, intraoperative bleeding rate and total surgical times.

A promising approach for screening pulmonary hypertension based on frontal chest radiographs using deep learning: A retrospective study.

BACKGROUND: To date, the missed diagnosis rate of pulmonary hypertension (PH) was high, and there has been limited development of a rapid, simple, and effective way to screen the disease. The purpose of this study is to develop a deep learning approach to achieve rapid detection of possible abnormalities in chest radiographs suggesting PH for screening patients suspected of PH. METHODS: We retrospectively collected frontal chest radiographs and the pulmonary artery systolic pressure (PASP) value measured by Doppler transthoracic echocardiography from 762 patients (357 healthy controls and 405 with PH) from three institutes in China from January 2013 to May 2019. The wohle sample comprised 762 images (641 for training, 80 for internal test, and 41 for external test). We firstly performed a 8-fold cross-validation on the 641 images selected for training (561 for pre-training, 80 for validation), then decided to tune learning rate to 0.0008 according to the best score on validation data. Finally, we used all the pre-training and validation data (561+80 = 641) to train our models (Resnet50, Xception, and Inception V3), evaluated them on internal and external test dataset to classify the images as having manifestations of PH or healthy according to the area under the receiver operating characteristic curve (AUC/ROC). After that, the three deep learning models were further used for prediction of PASP using regression algorithm. Moreover, we invited an experienced chest radiologist to classify the images in the test dataset as having PH or not, and compared the prediction accuracy performed by deep learing models with that of manual classification. RESULTS: The AUC performed by the best model (Inception V3) achieved 0.970 in the internal test, and slightly declined in the external test (0.967) when using deep learning algorithms to classify PH from normal based on chest X-rays. The mean absolute error (MAE) of the best model for prediction of PASP value was smaller in the internal test (7.45) compared to 9.95 in the external test. Manual classification of PH based on chest X-rays showed much lower AUCs compared to that performed by deep learning models both in the internal and external test. CONCLUSIONS: The present study used deep learning algorithms to classify abnormalities suggesting PH in chest radiographs with high accuracy and good generalizability. Once tested prospectively in clinical settings, the technology could provide a non-invasive and easy-to-use method to screen patients suspected of having PH.

[Research situation of acute retinal necrosis].

Acute retinal necrosis is an uncommon but devastating, potentially blinding ophthalmopathy characterized by acute uveitis, vitreitis, retinal arteritis and full-thickness retinal necrosis, frequently complicated by secondary retinal detachment and proliferative vitreoretinopathy in late stages. However, it usually cannot be diagnosed and treated promptly, with unfavorable prognosis for the lesions tend to a rapid circumferential progression in few days. This review summarizes the epidemiology, pathogenesis, clinical features, diagnosis, differential diagnosis and recent situation in the study of treatment of acute retinal necrosis.

[Diagnosis and treatment of eye diseases associated with HIV infection and AIDS].

OBJECTIVE: To investigate the manifestations and treatment principles of ocular diseases associated with human immunodeficiency virus infection (HIV) and acquired immunodeficiency syndrome (AIDS). METHODS: It was a retrospective case series. One hundred and ten patients were recruited. Two hundred and twenty eyes underwent ophthalmologic examination that included vision acuity, anterior segment and fundus examinations with papillary dilation and fundus fluorescein angiography. CD(4)(+)T-lymphocyte was counted in peripheral blood of 110 patients. Intravitreal injection of ganciclovir 400 microg was performed in 4 eyes (2 patients) with cytomegalovirus (CMV) retinitis associated with AIDS. All statistical analyses were performed using SPSS 13.0 software. The association between the age, duration of HIV infection and HIV/AIDS related ocular manifestations was analyzed by Pearson Correlation Analysis. The association between the gender and HIV/AIDS related ocular manifestations was analyzed by Pearson Chi-Square test. For comparison of the CD(4)(+)T cells counts of the patients with normal fundus, HIV retinopathy, CMV retinitis, Kruskal-Wallis Test for Several Independent Samples was used. RESULTS: Baseline visual acuity: no light perception (NLP) 5 eyes; light perception (LP) to 0.04, 10 eyes; 0.05 to 0.2, 14 eyes; 0.3 to 0.7, 62 eyes and >/= 0.8, 129 eyes. Small grayish keratin precipitates or pigment keratin precipitates were present in 25 eyes, 22 eyes had positive aqueous flare, 4 eyes had posterior synechia of the iris, 28 eyes had cataract. HIV retinopathy was present in 34 eyes. Cotton-wool spots, retinal hemorrhages, and retinal microaneurysms were found in eyes with HIV retinopathy. CMV retinitis was present in 32 eyes. The fundus manifestations of CMV retinitis included retinal vasculitis; dense, full-thickness, yellow-white lesions along vascular distribution with irregular granules at the border, and hemorrhage on the retinal surface in 26 eyes. Late stage retinopathy was demonstrated in 3 eyes characterized as atrophic retina, sclerotic and attenuated vessels, and optic nerve atrophy. Retinal detachment was found in 3 eyes. The median of CD(4)(+)T-lymphocyte counts of the patients with normal fundus was 100.0/mm(3). The median of CD(4)(+)T-lymphocyte counts of the patients with HIV retinopathy was 41.0/mm(3). The median of CD(4)(+)T-lymphocyte counts of the patients with CMV retinitis was 18.0/mm(3). The difference of CD(4)(+)T-lymphocyte counts between patients with normal fundus and HIV retinopathy was statistically significant (chi(2) = 4.848, P = 0.028). The difference of CD(4)(+)T-lymphocyte counts between patients with normal fundus and CMV retinitis was statistically significant (chi(2) = 15.696, P = 0.000). The difference of CD(4)(+)T-lymphocyte counts between patients with CMV retinitis and HIV retinopathy was statistically significant (chi(2) = 4.860, P = 0.027). Four eyes (2 patients) with CMV retinitis underwent intravitreal injection of ganciclovir 400 microg. After intravitreal injection of ganciclovir, visual acuity was improved and fundus lesions disappeared in 4 eyes. CONCLUSIONS: HIV retinopathy is a common intraocular complication in HIV-infected patients. CMV retinitis is the severest intraocular complication in patients with AIDS. Highly active anti-retroviral therapy allows immune reconstitution. Intravitreal injection of ganciclovir can effectively control CMV retinitis and save the vision.

LncRNA LINC00460 promotes tumor growth of human lung adenocarcinoma by targeting miR-302c-5p/FOXA1 axis.

Accumulating evidence has shown that long non-coding RNAs (lncRNAs) had malfunctioning roles in the development of human cancers, especially lung adenocarcinoma (LC). In the present study, we aimed to investigate the role and potential mechanism of lncRNA long intergenic non-protein coding RNA 460 (LINC00460) in LC progression using human tissues and cell lines. We observed that LINC00460 was increased in lung adenocarcinoma tissues and cells in comparison to their corresponding controls. Moreover, overexpression of LINC00460 indicated the poor prognosis of lung adenocarcinoma patients. In addition, silencing LINC00460 was able to suppress lung adenocarcinoma cell growth in vitro and in vivo. Rescue assay confirmed that LINC00460 contributed to lung adenocarcinoma progression by regulating miR-302c-5p/FOXA1 signal pathway. In conclusion, LINC00460 promotes LC progression by competitively binding miR-302c-5p and regulating FOXA1 signal pathway. Our findings reveal that LINC00460 may be a potential prognostic biomarker and a candidate target for LC therapy.

Fundus manifestations and HIV viral loads of AIDS patients before and after HAART.

AIM: To investigate the fundus manifestations and human immunodeficiency virus (HIV) viral loads of acquired immune deficiency syndrome (AIDS) patients before and after highly active antiretroviral therapy (HAART). METHODS: This retrospective study included 21 AIDS patients (42 eyes) who presented to the Department of Ophthalmology, Peking Union Medical College Hospital, from 2007 to 2011. Among the patients, 16 showed a good response to HAART, 3 presented drug resistance and 2 were pre-HAART. All patients underwent comprehensive ophthalmic examinations. The HIV viral loads and the CD4+ T-cell counts were also determined. RESULTS: The best-corrected visual acuity (BCVA) of 38 eyes (19 patients) was improved, and cytomegalovirus retinitis (CMVR) in 5 eyes (3 patients) regressed after HAART. Furthermore, 16 patients treated with effective HAART had decreased plasma HIV viral loads (<78 copies/mL) and increased CD4+ T-cell counts (343±161 cells/µL, P<0.005), but the HIV viral load in tears was still detected at 2404 copies/mL. The CD4+ T-cell count was lower in the CMVR group than in the non-CMVR group (P=0.022), but the HIV viral load in the tears was not significantly different between the two groups (P=0.439). CONCLUSION: Most patients with AIDS show a good viral response with a decreased HIV viral load and an increased CD4+ T-cell count in plasma after HAART. However, the HIV viral load remain quite high in the tear samples. Based on our results, we suggest that AIDS patients undergo long-term HAART that should not be interrupted.

Varicella-zoster virus as a causative agent of acute retinal necrosis in younger patients.

BACKGROUND: Herpes virus is considered to be the pathogen of acute retinal necrosis (ARN) infection. Previous studies have found that patients with ARN caused by the varicella-zoster virus (VZV) are often older, and patients with herpes simplex virus (HSV) induced ARN are considerably younger. However, in our clinical work, we find that VZV is also a pathogen in younger ARN patients. We, therefore, aimed to analyze the common etiology of younger ARN patients. METHODS: A retrospective analysis was made of 20 eyes (18 patients) diagnosed as having ARN in the Department of Ophthalmology of Peking Union Medical College Hospital from 2014 to 2016. All patients were reviewed for demographic data, clinical course, clinical manifestations, time from onset to initial physician visit, duration of follow-up, visual acuity at both presentation and final visit, and treatment strategies. A paired t test was used to compare visual acuity between the presenting vision and those of final follow-up. Vitreous or aqueous specimens from 18 eyes of 18 patients were analyzed with multiplex polymerase chain reaction (mPCR)/quantitative PCR (qPCR) and xTAG-liquid chip technology (xTAG-LCT) to determine the causative virus of ARN. RESULTS: Final best visual acuity (BCVA) improved significantly from 1.36 ±â€Š0.95 (median 20/400) to 0.95 ±â€Š0.82 (median 20/100) (t = 2.714, P = 0.015) after systemic and intravitreal antiviral treatment combined with or without pars plana vitrectomy. PCR and xTAG-LCT results showed four of the five samples in the younger group (32.2 ±â€Š5.2 years) and 12 of the 13 samples in the senior group (53.6 ±â€Š4.9 years) were positive for VZV, and two of the five samples in the younger group were positive for HSV-1. CONCLUSIONS: This study demonstrates that VZV is also a common causative virus for ARN in younger patients. Considering this finding, a systemic antiviral treatment protocol should be immediately changed to intravenous ganciclovir when the patient does not respond to acyclovir before determining the causative virus, especially in younger patients.